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Abstract：
OBJECTIVE: To measure regulatory T cell (Treg) levels in the peripheral blood of children with juvenile idiopathic arthritis (JIA) and analyse the association of this measure with disease activity, quality of life, adjustment of treatment, and hospitalisation.
METHODS: We conducted a two-phase study (cross-sectional and prospective), including consecutive children with a JIA diagnosis according to ILAR criteria. Our independent variables were Tregs, Th1, Th2, and cytokines in peripheral blood, and our dependent variables in the cross-sectional phase were arthritis category, JIA activity, and patient-reported outcomes. To test associations, we used Spearman\'s correlation coefficient and the Mann-Whitney U test. In the prospective phase, we explored the probability of treatment adjustment and hospitalisation for JIA during follow-up according to Tregs levels at baseline, using Cox proportional regression.
RESULTS: Our sample included 87 participants (median age 11 years, 63.2% girls). Tregs were not associated with most variables of interest. However, we found that higher Tregs concentration was associated with lower erythrocyte sedimentation rate (ESR) and better subjective disease status and course, while higher IL-10 and TGF-β levels were associated with lower ESR, less pain, and better subjective disease status We found no association between Tregs and treatment adjustments or hospitalisation.
CONCLUSIONS: Higher baseline Treg levels in the peripheral blood of children with JIA may be associated with reduced disease activity and better quality of life, though were not informative on the inflammatory progression on the follow-up.
METHODS: We conducted a two-phase study (cross-sectional and prospective), including consecutive children with a JIA diagnosis according to ILAR criteria. Our independent variables were Tregs, Th1, Th2, and cytokines in peripheral blood, and our dependent variables in the cross-sectional phase were arthritis category, JIA activity, and patient-reported outcomes. To test associations, we used Spearman\'s correlation coefficient and the Mann-Whitney U test. In the prospective phase, we explored the probability of treatment adjustment and hospitalisation for JIA during follow-up according to Tregs levels at baseline, using Cox proportional regression.
RESULTS: Our sample included 87 participants (median age 11 years, 63.2% girls). Tregs were not associated with most variables of interest. However, we found that higher Tregs concentration was associated with lower erythrocyte sedimentation rate (ESR) and better subjective disease status and course, while higher IL-10 and TGF-β levels were associated with lower ESR, less pain, and better subjective disease status We found no association between Tregs and treatment adjustments or hospitalisation.
CONCLUSIONS: Higher baseline Treg levels in the peripheral blood of children with JIA may be associated with reduced disease activity and better quality of life, though were not informative on the inflammatory progression on the follow-up.
摘要：
目的：测定幼年特发性关节炎(JIA)患儿外周血调节性T细胞(Treg)水平，并分析该指标与疾病活动性的关系。生活质量,调整治疗,和住院。
方法：我们进行了一项两阶段研究（横断面和前瞻性），包括根据ILAR标准诊断为JIA的连续儿童。我们的自变量是Tregs，外周血中Th1、Th2和细胞因子，我们在横截面阶段的因变量是关节炎类别，JIA活动，和患者报告的结果。要测试关联，我们使用Spearman相关系数和Mann-WhitneyU检验。在预期阶段，我们根据基线时的Tregs水平，探讨了JIA在随访期间调整治疗和住院的可能性，使用Cox比例回归。
结果：我们的样本包括87名参与者（中位年龄11岁，63.2%的女孩)。Tregs与大多数感兴趣的变量无关。然而,我们发现，较高的Tregs浓度与较低的红细胞沉降率（ESR）和更好的主观疾病状态和病程有关，而较高的IL-10和TGF-β水平与较低的ESR相关，更少的痛苦，我们发现Tregs与治疗调整或住院之间无关联。
结论：JIA患儿外周血中较高的基线Treg水平可能与疾病活动度降低和生活质量改善有关，尽管在随访中没有提供有关炎症进展的信息。
方法：我们进行了一项两阶段研究（横断面和前瞻性），包括根据ILAR标准诊断为JIA的连续儿童。我们的自变量是Tregs，外周血中Th1、Th2和细胞因子，我们在横截面阶段的因变量是关节炎类别，JIA活动，和患者报告的结果。要测试关联，我们使用Spearman相关系数和Mann-WhitneyU检验。在预期阶段，我们根据基线时的Tregs水平，探讨了JIA在随访期间调整治疗和住院的可能性，使用Cox比例回归。
结果：我们的样本包括87名参与者（中位年龄11岁，63.2%的女孩)。Tregs与大多数感兴趣的变量无关。然而,我们发现，较高的Tregs浓度与较低的红细胞沉降率（ESR）和更好的主观疾病状态和病程有关，而较高的IL-10和TGF-β水平与较低的ESR相关，更少的痛苦，我们发现Tregs与治疗调整或住院之间无关联。
结论：JIA患儿外周血中较高的基线Treg水平可能与疾病活动度降低和生活质量改善有关，尽管在随访中没有提供有关炎症进展的信息。
