3A-S7-1

ARTHRITIS IN CHILDREN: NATURE OR NURTURE?

Patricia Woo

Windeyer Institute of Medical Sciences, University College London, UK

Acute arthritis often presents in childhood as a reaction to intercurrent infections. These include viruses such as herpes, entero and influenza viruses, bacteria such as streptococcus, and mycoplasma, Chronic arthritis occur in 1: 10,000 children in the western world and there is often a history of an inter-current illness proceeding the onset. Epidemiological studies to-date however is not supportive of a primarily infectious aetiology, and therefore genetic factors are also important in the pathogenesis of these chronic arthritides.

Data on the associations of different types of juvenile idiopathic arthritis (JIA) and the genes responsible for the immune and inflammatory responses will be reviewed. These include the HLA class I and II genes, and cytokine genes. A truly polygenic model is emerging as the cause of JIA. Strategies of how to make biological sense of the information will be discussed.