| 1. |
- Gudmundsdottir, J. A., et al.
(författare)
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Normal neonatal TREC and KREC levels in early onset juvenile idiopathic arthritis
- 2023
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Ingår i: Clinical Immunology. - : Elsevier BV. - 1521-6616 .- 1521-7035. ; 249
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Dysregulated central tolerance predisposes to autoimmune diseases. Reduced thymic output as well as compromised central B cell tolerance checkpoints have been proposed in the pathogenesis of juvenile idiopathic arthritis (JIA). The aim of this study was to investigate neonatal levels of T-cell receptor excision circles (TRECs) and kappa-deleting element excision circles (KRECs), as markers of T-and B-cell output at birth, in patients with early onset JIA.Methods: TRECs and KRECs were quantitated by multiplex qPCR from dried blood spots (DBS), collected 2-5 days after birth, in 156 children with early onset JIA and in 312 matched controls.Results: When analysed from neonatal dried blood spots, the median TREC level was 78 (IQR 55-113) in JIA cases and 88 (IQR 57-117) copies/well in controls. The median KREC level was 51 (IQR 35-69) and 53 (IQR 35-74) copies/well, in JIA cases and controls, respectively. Stratification by sex and age at disease onset did not reveal any difference in the levels of TRECs and KRECs.Conclusion: T-and B-cell output at birth, as measured by TREC and KREC levels in neonatal dried blood spots, does not differ in children with early onset JIA compared to controls.
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| 2. |
- Dimitrijevic Carlsson, Alexandra, 1966-, et al.
(författare)
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Juvenile idiopathic arthritis and the temporomandibular joint : a case-control study of magnetic resonance imaging findings in relation to clinical and psychosocial factors
- 2023
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Ingår i: European Journal of Paediatric Dentistry. - : Società Italiana di Odontoiatria Infantile. - 1591-996X .- 2035-648X. ; 24:1, s. 69-76
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Tidskriftsartikel (refereegranskat)abstract
- AimIn juvenile idiopathic arthritis (JIA), the temporomandibular joint (TMJ) is a particularly challenging joint to assess both clinically and with imaging. The aim of this article is to investigate TMJ magnetic resonance imaging (MRI) findings in relation to clinical and psychosocial factors in patients with JIA and healthy individuals related to TMJ arthritis in JIA.Material and methods In total, 45 patients (6–16 years) with JIA and 16 healthy age- and sex-matched controls were examined according to the diagnostic criteria for temporomandibular disorders (DC/TMD). The subjects answered questionnaires about psychosocial factors (pain intensity, pain-related disability, depression, stress, catastrophising, pain locations, and jaw function) and underwent bilateral MRI of the TMJ.ResultsThere were no significant differences between JIA patients and healthy individuals in any of the TMJ MRI findings. Moderate/severe changes among JIA patients were found only for effusion, synovial thickening, condylar flattening, and erosion, with no moderate/severe changes in healthy individuals. In JIA patients, orofacial pain intensity was related to TMJ bone marrow oedema, and pain in jaw muscles during jaw function was related to TMJ bone marrow oedema and erosion. There were no significant correlations between psychosocial aspects and MRI findings.ConclusionsThis study indicates a substantial overlap of TMJ MRI findings in both the inflammatory domain and the damage domain between JIA patients and healthy individuals. In JIA patients, the inflammatory MRI sign of bone marrow oedema seems to influence orofacial pain intensity.
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| 3. |
- Kindgren, Erik, 1977-
(författare)
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Early Life Environmental Risk Factors and Gut Microbiota in Juvenile Idiopathic Arthritis : - More than a gut feeling
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The autoimmune disease juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children, but the cause is not fully established. Only a small percentage (13–18%) of the risk of contracting the disease can be attributed to genetic factors, but environmental factors are believed to be behind most of the risk. An unfavourable composition of gut bacteria has also been suggested as a factor that may increase the risk of developing JIA. Aims: The main aim of this thesis was to study risk factors during fetal life and in the early childhood environment for future onset of JIA. A further aim was to study the composition and importance of the gut microbiota before the onset of JIA. Methods: In the ABIS study, a population-based prospective birth cohort of 17,055 children, data were collected on environmental factors during pregnancy and childhood. We identified 111 individuals with a JIA diagnosis. Environmental factors were mainly analysed using multivariable logistic regression, with adjustment for confounding factors. The microbiome at one year of age was analysed from stool samples by 16S rRNA PCR. Results: Significant associations could be noted between mode of birth, duration of breastfeeding, birth order and exposure to antibiotics or fish early in life with future onset of JIA. These risk factors were found to pose an even higher cumulative risk if several of the factors were present. Carrying a risk allele in combination with being exposed to a specific environmental factor further increased the risk. In addition, several taxa were identified in the gut microbiota at one year that were associated with future onset of JIA. Many of these taxa were associated with one or more of the identified early childhood environmental risk factors. Conclusion: In these studies, it has been demonstrated that children with JIA have, very early in life, already been exposed to negative environmental factors (caesarean section, short-term breastfeeding, being firstborn and being exposed to antibiotics or fish during the first year of life). The effect from these risk factors appears to be to some extent mediated via a changed composition of the gut microbiota. An environmentally induced dysregulation of the microbiome can trigger or accelerate the development of JIA in genetically predisposed children.
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| 4. |
- Kindgren, Erik, 1977-, et al.
(författare)
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Prevalence of ADHD and Autism Spectrum Disorder in Children with Hypermobility Spectrum Disorders or Hypermobile Ehlers-Danlos Syndrome: A Retrospective Study
- 2021
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Ingår i: Neuropsychiatric Disease and Treatment. - : DOVE MEDICAL PRESS LTD. - 1176-6328 .- 1178-2021. ; 17, s. 379-388
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) are both characterized by generalized hypermobility, in combination with pain, affected proprioception, and pronounced fatigue. Clinical observation indicates that behavioral problems, hyperactivity, and autistic traits are overrepresented in children with those conditions. The purpose of this retrospective study was to establish the prevalence of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) among children with HSD and hEDS treated in our clinic since 2012. Subjects and Methods: Since Ehlers-Danlos syndrome (EDS) diagnostic criteria and international classification were changed in 2017, we equate the older diagnosis EDS hypermobility type with the newer hEDS and the older hypermobility syndrome with HSD. A registry search from the computerized medical record system found 201 children (88 boys, 113 girls) aged 6– 18 years who were treated at our pediatrics department with the diagnoses HSD or EDS. All medical records (113 with HSD, 88 with EDS) were reviewed, and key symptoms such as fatigue and pain, as well as diagnosis of ADHD/ASD, were recorded. Results: All EDS cases could be classified as hEDS. Of the entire study cohort, 16% had a verified ADHD diagnosis and a further 7% were undergoing ADHD diagnostic investigation. Significantly more children with hEDS had ADHD compared to children with HSD (p=0.02). In the age group 15– 16 years, 35% of those with hEDS had ADHD and, among those aged 17– 18 years, ADHD was present in 46%. Children with coexisting ADHD showed a significantly higher proportion of associated symptoms such as fatigue, sleep-problems, and urinary tract problems. ASD had been verified in 6% of the children. Of those with ASD, 92% had sleep problems. Conclusion: This study shows a strong association between HSD or hEDS and ADHD or ASD. Therefore, children with HSD or hEDS may need to be routinely screened for neuropsychiatric symptoms.
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