Biological classification of childhood arthritis: roadmap to a molecular nomenclature

Chronic inflammatory arthritis in childhood is heterogeneous in presentation and course. Most forms exhibit clinical and genetic similarity to arthritis of adult onset, although at least one phenotype might be restricted to children. Nevertheless, paediatric and adult rheumatologists have historical...

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Bibliographic Details
Published in:Nature reviews. Rheumatology 2021-05, Vol.17 (5), p.257-269
Main Authors: Nigrovic, Peter A., Colbert, Robert A., Holers, V. Michael, Ozen, Seza, Ruperto, Nicolino, Thompson, Susan D., Wedderburn, Lucy R., Yeung, Rae S. M., Martini, Alberto
Format: Article
Language:English
Subjects:
692/308/3187
692/4017
692/4023/1670/427/1304
Arthritis
Arthritis, Juvenile - classification
Arthritis, Juvenile - genetics
Arthritis, Juvenile - metabolism
Child
Children
Classification
Computational Biology - methods
Development and progression
Genetic aspects
Humans
Identification and classification
Inflammation
Juvenile arthritis
Medicine
Medicine & Public Health
Nomenclature
Pediatric research
Pediatrics
Phenotype
Phenotypes
Polymorphism, Single Nucleotide
Review Article
Rheumatology
Terminology as Topic
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Summary:Chronic inflammatory arthritis in childhood is heterogeneous in presentation and course. Most forms exhibit clinical and genetic similarity to arthritis of adult onset, although at least one phenotype might be restricted to children. Nevertheless, paediatric and adult rheumatologists have historically addressed disease classification separately, yielding a juvenile idiopathic arthritis (JIA) nomenclature that exhibits no terminological overlap with adult-onset arthritis. Accumulating clinical, genetic and mechanistic data reveal the critical limitations of this strategy, necessitating a new approach to defining biological categories within JIA. In this Review, we provide an overview of the current evidence for biological subgroups of arthritis in children, delineate forms that seem contiguous with adult-onset arthritis, and consider integrative genetic and bioinformatic strategies to identify discrete entities within inflammatory arthritis across all ages. Childhood-onset arthritis has historically been treated as a separate entity to adult-onset arthritis, with its own nomenclature and classification system. Biological evidence has revealed the limitations of the current approach, necessitating a fresh look at the classification of paediatric arthritis.
ISSN:1759-4790
1759-4804
DOI:10.1038/s41584-021-00590-6