Human Protein Transthyretin Triggers Juvenile Arthritis

Connecting proteins with JIA may give clinicians a better understanding of what can trigger an autoimmune reaction of the joints in patients with the condition.

Associating proteins with juvenile idiopathic arthritis (JIA) may give clinicians a better understanding of what can trigger an autoimmune reaction of the joints in patients with the condition.

According to recent studies, JIA affects approximately 300 000 children across the United States. It is a heterogeneous disease, with oligoarticular and polyarticular subtypes being the most common.

TRENDING ON CPA: Obama Pledges Additional $1.1B to Combat Opioid Abuse

Led by researchers at Albert Einstein College of Medicine and the Children’s Hospital at Montefiore (CHAM), new research indicates that transthyretin (TTR), a human protein, causes an autoimmune reaction in the joint of patients with JIA.

For the study, the investigators searched for abnormal accumulations of proteins in both the synovial fluid and blood of patients with JIA (all patients met the Internataionall League Against Rheumatism criteria for JIA). They did not find TTR in any of the 26 control children who did not have JIA; however, the results did reveal that there was a significant increase in the protein in 50 patients at the Children’s Hospital at Montefiore. Analyzing further, the researchers learned that some JIA patients had unusually high levels of antibodies to the TTR protein. They analyzed 43 other patients with JIA to validate the finding. They found a substantial increase in TTR autoantibodies in all of them.

Study author Laura Santambrogio, MD, PhD, professor of pathology, microbiology & immunology, and of orthopaedic surgery at Albert Einstein, told Clinical Pain Advisor that she and her colleagues hope that the findings of this report “will lead to a simple biomarker test, which would help clinicians better diagnose a disease and/or to categorize different stages of the disease.”

“A larger cohort of patients needs to be analyzed, as well as patients with different subtypes of JIA and different stages of the disease, to help refine these initial findings,” Dr Santambrogio said.

The report was funded by grants from the National Institutes of Health (AG045223, AI38996, and AI48833, AR-47363, NIH AR-48929) and by the Cincinnati Children’s Research Foundation and the Cincinnati Genomic Control Cohort.

The authors report no conflicts of interest


Clementi CC, Moncrieffe H, Lele A, Janow G, Becerra A, Bauli F, et al. Autoimmune response to transthyretin in juvenile idiopathic arthritis. JCI Insight. 2016. doi: 10.1172/jci.insight.85633.