Correlation between disease severity and presence of ocular autoantibodies in juvenile idiopathic arthritis-associated uveitis.
OBJECTIVE
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.
Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany.
Karoline
K
Walscheid
Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany.
Maren
M
Hennig
Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany.
Carsten
C
Heinz
Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany.
Susanne
S
Wasmuth
Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany.
Martin
M
Busch
Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany.
Dirk
D
Bauer
Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany.
Martha
M
Dietzel
Institute of Animal Physiology, Department of Veterinary Sciences, LMU Munich, Germany.
Cornelia A
CA
Deeg
Department of Ophthalmology at St. Franziskus-Hospital, Muenster, Germany.
Arnd
A
Heiligenhaus
D000293:Adolescent; D000818:Animals; D000974:Antibodies, Antinuclear / Q000097:blood* / Q000276:immunology; D001171:Arthritis, Juvenile / Q000097:blood / Q000150:complications* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D012160:Retina / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D013552:Swine; D014606:Uveitis, Anterior / Q000097:blood / Q000209:etiology* / Q000276:immunology
D000974:Antibodies, Antinuclear
antinuclear antibodies; autoantibodies; juvenile idiopathic arthritis; pathogenesis; uveitis