Correlation between disease severity and presence of ocular autoantibodies in juvenile idiopathic arthritis-associated uveitis

Invest Ophthalmol Vis Sci. 2014 Apr 24;55(6):3447-53. doi: 10.1167/iovs.13-13444.

Abstract

Purpose: The pathogenesis of juvenile idiopathic arthritis-associated uveitis (JIAU) is undefined. This study intended to analyze the presence of antiocular autoantibodies in serum and their correlation with disease course.

Methods: Serum samples from children with JIAU (n = 47); JIA without uveitis (n = 67); idiopathic anterior uveitis (IAU; n = 12); and healthy controls (n = 52) were collected. The binding patterns of serum antibodies to ocular cryosections from swine eyes were analyzed by indirect immunohistochemistry, and were correlated to epidemiological, clinical, and laboratory test results.

Results: The patient groups differed with respect to their presence of antibody binding to the sections: JIAU (94%), JIA (75%), IAU (75%), and healthy controls (29%) to uveal and/or retinal structures. Serum antibodies of JIAU patients predominantly bound at iris (74%), and ciliary body (79%). Iris/ciliary body positive staining correlated with the presence of uveitis complications (P < 0.005) in JIAU patients, but not with positivity of serum antinuclear antibodies (ANA), rheumatoid factor (RF), or HLA-B27, and was independent from uveitis activity or type of anti-inflammatory therapy.

Conclusions: In JIAU patients, antiocular serum antibodies can be detected more frequently than in control groups. Binding patterns to ocular tissue correlate with complicated uveitis course but not with uveitis activity and anti-inflammatory treatment. Antibody binding is not specific for this uveitis entity, and does not correlate with ANA positivity.

Keywords: antinuclear antibodies; autoantibodies; juvenile idiopathic arthritis; pathogenesis; uveitis.

MeSH terms

  • Adolescent
  • Animals
  • Antibodies, Antinuclear / blood*
  • Antibodies, Antinuclear / immunology
  • Arthritis, Juvenile / blood
  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / immunology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Retina / pathology
  • Retrospective Studies
  • Risk Factors
  • Swine
  • Uveitis, Anterior / blood
  • Uveitis, Anterior / etiology*
  • Uveitis, Anterior / immunology

Substances

  • Antibodies, Antinuclear