Researcher Targets Arthritis in Children

About 300,000 children in the United States live with some form of rheumatic disease. The research of Homaira Rahimi, M.D., assistant professor of pediatrics, is aimed at helping 70,000 to 100,000 children in the U.S. with juvenile idiopathic arthritis (JIA) — a form of chronic arthritis involving combinations of swelling and pain in one or more joints, rash, fevers, inflammation of other organs (especially the eyes), and periods of remission and flareup, writes Susanne Pritchard Pallo at the Research@URMC blog.

JIA is an autoimmune disease in which the body's immune system attacks its own tissues, causing inflammation. Anti-tumor necrosis factor (anti-TNF) drugs are commonly used to halt inflammation associated with arthritis in adults and children, but nearly 40 percent of those populations do not respond to the drugs.

While other kinds of drugs exist for adult arthritis patients, many are not approved for use in children. Because of important ethical regulations and practical barriers to performing research studies on children, much of what is known about JIA comes from research in adults, which significantly limits the number of medications that are available to children.

That has led researchers to investigate alternate disease mechanisms and treatment approaches for the many different types of arthritis. For example, drainage of joint fluid via lymphatic vessels is impaired in arthritis. Rahimi is exploring whether improving drainage of arthritic joints can help patients who are resistant to anti-TNF medications.

She is also investigating possible links to diet. She has just begun studying the gut microbiome to understand whether certain bacteria in the intestines predispose patients to inflammation in their joints and other parts of their bodies. She suggests there are "good" and "bad" bacteria that must be kept in balance to combat arthritic inflammation. She is just beginning to test this theory using probiotics, like those touted on yogurt labels.

Rahimi hopes that controlling arthritis with diet may provide parents of arthritic children with natural alternatives in addition to traditional medicines that may carry side effects. However, she warns that diet may minimize the amount of drugs needed, but is not likely to cure the disease on its own.