7.1 Changes of antioxidative status and free radical damage in subsets of juvenile idiopathic arthritis (JIA) over a period of three months

JIA is an inflammatory disease in which the role of free radicals has not yet been clarified. We recently showed a specific pattern of antioxidative status and free radical damage in subsets of JIA.¹ We investigated whether this pattern is characteristic for subsets of disease or inflammatory activity.

Patients (n=85) with JIA were seen consecutively in the paediatric rheumatology unit during one year and again after three months. The disease subsets were: oligoarticular juvenile rheumatoid arthritis (oJRA, n=54), polyarticular JRA (pJRA, n=3), systemic JRA (sJRA, n=4), spondyloarthritis (SA, n=18), and psoriatic arthritis (n=6). Patients with non-inflammatory joint pain served as controls (n=15). Erythrocyte sedimentation rate (ESR), in vitro radical resistance of erythrocytes (RRE), total radical trapping ability of plasma (TRAP), malondialdehyde as marker of lipid peroxidation, sulphydryl (SH) groups, and α-tocopherol as antioxidants were analysed in blood.

According to the JIA subsets, the following differences were seen between the first and second visit: a decrease in the tender joint score in patients with oJRA (p<0.001) corresponding with an increase of α-tocopherol (p<0.05) and TRAP (p<0.01). All patients with JIA were stratified according to inflammatory disease activity into groups with low (<20 mm/1st h), medium (20–40 mm/1st h), and high ESR (>40 mm/1st h). The differences seen between these groups and controls during the first visit (increase of in vitro RRE (high ESR); and decrease in SH groups (medium ESR)) were not seen again during the second visit.

The increase in antioxidative potential and simultaneous decrease of tender joint score in patients with oJRA underline the role of antioxidants in JIA. It remains to be elucidated whether the change of pattern according to inflammatory disease activity means that there is no characteristic reproducible pattern of antioxidative status and free radical damage in relation to inflammatory disease activity.

7.2 Growth disturbances in patients with juvenile idiopathic arthritis (JIA): Has the prevalence changed?

Previous studies have …