Cytokines in children with arthritis

An imbalance between pro- and anti-inflammatory cytokines appears to exist in children with JIA. More abundant anti-inflammatory cytokines in children with persistent oligoarticular JIA partly may explain the relatively benign nature of this subgroup. Differences in the genetic control of transcription of IL-6 and IL-10 genes have been found to be associated with disease subgroups and may well be important in the pathogenesis or disease severity of these JIA subgroups. Further studies of other cytokine genes within the cytokine network are needed. Drugs used in the treatment of JIA may act partly by altering cytokine production and restoring cytokine homeostasis. In the future, genetic studies may allow one to give a patient a reliable prognosis based on accumulated odds ratios for different cytokine genotypes as well as other associated genes. The elucidation of cytokine imbalances will also provide molecular targets for the development of more specific and safer means of therapy.