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Can we protect kids with arthritis from vision loss?

A better understanding of the link between childhood arthritis and eye inflammation that can lead to blindness is being developed thanks to a Saskatchewan-based research team led by Pediatric Rheumatologist Dr. Alan Rosenberg.

Dr. Alan Rosenberg

Arthritis affects around 24,000 Canadian children. It is one of the most common chronic childhood diseases, and up to 60% of children with arthritis will continue to have arthritis as adults – many children with arthritis experience uveitis, a condition that causes eye inflammation. Patients have described arthritis and uveitis as life-altering; with devastating consequences that can affect growth, development and quality of life both as a child and later as an adult. Despite intensive treatments, up to one-third of children with uveitis develop permanent vision loss and blindness. 

What causes juvenile idiopathic arthritis (JIA) and uveitis in children is not yet completely understood. It’s also not understood why the two conditions occur together, or why being a girl, having a young onset age, and having a positive test for markers in the blood increase the risk for uveitis in these young patients.

Dr. Rosenberg hopes to change this using funding from Jim Pattison Children’s Hospital Foundation. Preliminary data have been collected to explain how collagen, an essential protein in both joints and eyes, changes in a way that promotes inflammation in children with both arthritis and uveitis. Children with JIA and associated uveitis have different markers in the blood than kids without uveitis.  These findings are expected to help predict which children are at highest risk for developing uveitis, guide treatment, and improve outcomes. The preliminary data collected has allowed Dr. Rosenberg to assemble an international, multi-disciplinary research team made up of members across Canada, the United States, and the Netherlands.

“Funding provided by Jim Pattison Children’s Hospital Foundation has been essential for allowing our Saskatchewan-led, international team to undertake this research that we believe will explain why some children with arthritis develop eye inflammation. With this new knowledge, earlier detection and more effective treatments will result,” said Dr. Alan Rosenberg. “With a better understanding of the reasons for this condition, cure and prevention become realistic goals. Through our strong international network, we can rapidly inform colleagues around the world of results of this research as they become available. “ 

The homegrown research team has demonstrated for the first time that the same protein that causes eye inflammation also causes joint damage. Also, they were able to show that the inflammatory reaction occurring from exposure to this protein suggests a reason for the link between eye and joint pathology in JIA.

“We are so excited to be a part of the incredible research being done right here in our home province,” said Brynn Boback-Lane, President and CEO, Jim Pattison Children’s Hospital Foundation. “With arthritis affecting so many children, it is critical that research projects like the one Dr. Rosenberg and his team are working on receive funding. We hope that these projects will lead to better treatments and outcomes for children not only in Saskatchewan but across the world.”

Dr. Rosenberg and his team have secured additional funding from the Canadian Arthritis Society and the University of Saskatchewan, College of Medicine to undertake an even more extensive, more definitive study. This second study is expected to confirm the findings from the initial research project.

“We are on the brink of astonishing discoveries that will help transform our understanding and care for children with arthritis,” said Dr. Rosenberg. “There is a genuine expectation that these discoveries will make cure and prevention realistically achievable.”

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