Pediatric rheumatology — one of the most vibrant and productive communities in the specialty — has several presentations at the Annual Meeting, but the best of the best are gathered in a single session, Pediatric Rheumatology Year in Review & Awards, from 1:00 – 2:00 pm Sunday in Room 25 A.
“This is the highest-impact session of the entire year for pediatric rheumatologists,” said Natasha M. Ruth, MD, MS, Associate Professor and Chief of Pediatric Rheumatology at the Medical University of South Carolina. “Whether you are a basic researcher, or involved in translational or clinical research, this is the one must-attend hour in all of ACR.”
Dr. Ruth will present the annual awards in pediatric rheumatology, including the James T. Cassidy Award from the AAP Section on Rheumatology that recognizes an individual for outstanding achievement in pediatric rheumatology. The rest of the session will be devoted to the Year in Review presentations.
Every advance in rheumatology begins with basic research. And while there have been dozens of insightful and scientifically sound studies published in the past year, a handful are likely to have the greatest impact on future research and, eventually, on clinical practice.
“Genetic susceptibility has been a key theme in basic research this past year,” said Robert Colbert, MD, PhD, Senior Investigator in the Pediatric Translational Research Branch of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. “Two important areas are genetic susceptibility in juvenile arthritis (JA) and new data implicating a specific gene, NLRP1, in autoinflammatory disease of the skin and the joints.”
Three new papers provide strong hints to some of the answers to long-standing questions about genetic overlap in different forms of JA. Data from an international consortium suggests that systemic JIA is genetically distinct from other forms of JA, while another paper suggests that polyarticular JA and oligoarticular JA share more similarities than differences at the genetic level. These two forms of arthritis, which appear to be unique to childhood, also share several regions of genetic susceptibility that have not been previously reported for other autoimmune diseases.
A third area of intense interest is the microbiome.
“It is very clear that the microbiota, in particular the bacteria that reside in our mouth, in our gut, and on our skin, are involved in many different immune-mediated and autoimmune diseases,” Dr. Colbert said. “What has been puzzling for a number of years is that the number of bacteria on the surface of the eye is one-thousand to one-million fold lower than in other mucosal and conjunctival areas such as the saliva. It has not been clear whether there even is an ocular microbiome and whether it plays a role in the normal immune and physiological state of the eye. The answer appears to be yes on all counts.”
A recent mouse study confirmed the presence of a specific Corynebacterium that resides on the surface of the eye and appears to protect the eye from infection with Pseudomonas, Candida, and other potential ocular infections.
“The mice were protected by the induction of IL-17, coming from a specific population of T cells that are particularly important for recruiting neutrophils to dispose of intruding bacteria,” Dr. Colbert said. “Researchers are going to be looking more and more at the ocular microbiome as a part of the picture of uveitis and inflammatory eye disease.”
Timothy Beukelman, MD, Associate Professor of Pediatrics at the University of Alabama at Birmingham, will present the most impactful and insightful research papers in clinical research. He was the lead author for the 2011 “ACR Recommendations for the Treatment of JIA.”
Lucy Wedderburn, Professor in Paediatric Rheumatology at University College London Institute of Child Health and a consultant at Great Ormond Street Hospital, London, will present the best of the year’s translational research.