title: Gut microbiota-host interactions and juvenile idiopathic arthritis.
abstract: BACKGROUND
  Juvenile idiopathic arthritis is the most common form of chronic arthritis in children. There is mounting evidence that the microbiota may influence the disease.
  
  
  METHODS
  Recent observations in several systemic inflammatory diseases including JIA have indicated that abnormalities in the contents of the microbiota may be factors in disease pathogenesis, while other studies in turn have shown that environmental factors impacting the composition of the microbiota, such as delivery mode and early exposure to antibiotics, affect the risk of chronic inflammatory diseases including JIA. Microbial alterations may predispose to JIA through a variety of mechanisms, including impaired immunologic development, alterations in the balances of pro- versus anti-inflammatory bacteria, and low-grade mucosal inflammation. Additional confirmatory studies of microbiota aberrations and their risk factors are needed, as well as additional mechanistic studies linking these alterations to the disease itself.
  
  
  CONCLUSIONS
  The microbiota may influence the risk of JIA and other systemic inflammatory conditions through a variety of mechanisms. Additional research is required to improve our understanding of the links between the microbiota and arthritis, and the treatment implications thereof.
authors.affiliation: Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.|Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.|PEDEGO Research Unit, University of Oulu, Oulu, Finland.
authors.forename: Miika
authors.initials: M
authors.lastname: Arvonen
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Lillemor
authors.initials: L
authors.lastname: Berntson
authors.affiliation: Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.|PEDEGO Research Unit, University of Oulu, Oulu, Finland.|Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
authors.forename: Tytti
authors.initials: T
authors.lastname: Pokka
authors.affiliation: Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.|Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.|Department of Pathology, Oulu University Hospital, Oulu, Finland.
authors.forename: Tuomo J
authors.initials: TJ
authors.lastname: Karttunen
authors.affiliation: Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.|PEDEGO Research Unit, University of Oulu, Oulu, Finland.|Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Vähäsalo
authors.affiliation: Department of Pediatrics, University of Alabama at Birmingham, CPP N 210 M, 1600 7th Avenue South, Birmingham, AL, 35233, USA. mstoll@peds.uab.edu.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Stoll
mesh_terms: D001171:Arthritis, Juvenile / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D064806:Dysbiosis / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D000069196:Gastrointestinal Microbiome / Q000502:physiology*; D054884:Host-Pathogen Interactions / Q000502:physiology*; D006801:Humans; D012307:Risk Factors
keywords: Antibiotics; Juvenile arthritis; Microbiota