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July is Juvenile Arthritis Awareness Month

In July each year, we observe Juvenile Arthritis Awareness Month. It is important to raise public knowledge about this painful and debilitating condition, because in the public’s eye, arthritis is associated primarily with older people, so it can easily be overlooked or underrated in its actual importance for younger people. 

Fact #1 – Juvenile arthritis affects many children in the US

Classified broadly as Juvenile idiopathic arthritis (JIA), it encompasses a number of sub-groups including;

  • Juvenile Ankylosing Spondylitis
  • Juvenile Dermatomyositis
  • Juvenile Scleroderma
  • Systemic Juvenile Idiopathic Arthritis
  • Fibromyalgia
  • Lupus
  • Kawasaki Disease

These affect nearly 300,000 kids and teens in the country. “Idiopathic” means the causes or triggers are unknown. JIA develops when the adaptive immune system becomes overactive and starts to attack healthy tissues, so it falls into the category of autoimmune diseases.

Fact #2 – In children, arthritis may not be limited just to joints, but also affect other organs

As well as the most common effect of arthritis causing joint inflammation, it can also affect the eyes, skin, and the GI tract.

In fact, the gastrointestinal tract plays multiple roles when it comes to arthritis generally, A healthy GI tract houses the largest number of immune cells in the body and so it plays a critical role in overall body health. When the immune system is not functioning well, it can result in the most common types of inflammatory arthritis including gout, rheumatoid arthritis, psoriatic arthritis and JIA. 

Apart from their role of digesting food, producing vitamins and controlling the growth of cells, the trillions of microbes in the GI teach the immune system the difference between harmless and dangerous bacteria – distinguishing friend from foe and attacking intruders. The process activates inflammatory T-cells to hunt-and-destroy the intruders. The process should then be halted by expression of anti-inflammatory T-cells to get everything back to normal. However, when there are too many pro-inflammatory T-cells (or not enough anti-inflamma­tory T-cells to suppress them) it can incite bouts of inflammatory types of arthritis. Basically, the T-cells are attacking healthy tissue instead of killing any invading organisms.

According to Dr. Jose Scher of the Microbiome Center for Rheumatology and Autoimmunity at NYU Langone Health in New York City, one of the nation’s premier academic medical centers, studies have shown that patients with JIA had abnormalities and less diversity in their gut microbes. Dr. Scher says the loss of protective bacteria means the immune system can’t regulate inflam­mation.

“A change in cell biology may allow inflammatory chemicals to es­cape from gut tissue to other parts of the body,” he explains. These inflammatory cells can attack joints and set the stage for inflammation in internal organs.

Fact #3 – Treatments for juvenile arthritis are shifting to drug-based regimes

There is no cure for JIA but achieving a reduction in the levels of disease activity and symptoms is possible.  Early aggressive treatment as quickly as possible is the key to getting the disease under control. The introduction of targeted medications for JIA has seen a revolution in treatments. 

Before this, typical treatment consisted of pain relief aimed simply at reducing the symptoms. The standard approach was to start with nonsteroidal anti-inflammatory drugs (NSAIDs) and if they don’t relieve the symptoms sufficiently within one week, to step up to high doses of corticosteroids, to be administered orally or through IV infusion. These should quickly reduce fever, other systemic symptoms, as well as joint pain and swelling.

However, long-term high-dose administration of corticosteroids in children may cause serious side effects. These include osteoporosis, increased risk of infection and slowed growth. 

When JIA is active and not well controlled, the disease itself may hamper the immune system’s ability to fight off bacteria and so increase the risk of infection.

Fact #4 – A short history of Juvenile Arthritis Awareness Month

In the 1970s, organizations like the American Rheumatism Association (ARA) and the International League Against Rheumatism (ILAR) recognized that JIA needed to be studied more thoroughly, and better treatments developed.

In 1976, the first conference dedicated to Pediatric Rheumatology was hosted by the American Rheumatism Association (ARA) at a time when there were fewer than 30 specialist pediatric rheumatologists in the U.S.

Blue ribbons are used to represent juvenile arthritis awareness.

The campaign that established the month was founded by the Arthritis Foundation, seeking to raise awareness about this condition and share resources to help the younger people who are affected by it. 

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