Researchers have found a way to predict when children with arthritis may have painful flare-ups in their joints.
It means flare-ups could be prevented by giving patients the right medication at the right time.
In childhood arthritis (the autoimmune condition called Juvenile Idiopathic Arthritis or ‘JIA’), flares happen when immune cells mistakenly attack the joints.
These flares can occur very unpredictably, without warning, on or off medication.
Regulatory T cells (or Tregs) normally keep the immune system in balance so that rogue immune cells don’t attack the body’s own tissues. But in autoimmunity, like JIA, it is thought that Tregs may not be fit for service.
The BRC-supported research team, led by Dr Anne Pesenacker, investigated the role of Tregs in JIA. They looked at 48 different genes in Tregs from patient blood samples, and analysed these genes through the use of machine learning.
The team worked out which Treg genes and proteins are associated with active JIA (where individuals have inflamed joints) and which are associated with ‘inactive’ JIA (where individuals do not have inflamed joints but still don’t feel completely well). Currently there is no objective lab test for this ‘sub-clinical’ disease activity.
By looking at these patterns, the team said it could be possible to predict which children were likely to have a flare-up in the near future.
Dr Pesenacker, of the UCL Division of Infection and Immunity, said: “We found that the characteristics of Tregs are an important factor in JIA activity and remission. Our findings suggest that Tregs change over time, and analysing Tregs in the blood could potentially be used in clinic in future to guide treatment decisions to prevent flares. We hope this could help more young people achieve a better quality of life.”
The findings are published in the March 2025 edition of the Journal of Autoimmunity.
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