"Environmental risk factors associated with juvenile idiopathic arthritis associated uveitis: a systematic review of the literature"

Sarah L N Clarke; Katie S Mageean; Henry Carlton; Gabriele Simonini; Gemma C Sharp; Caroline L Relton; Athimalaipet V Ramanan

doi:10.1186/s12348-021-00247-1

"Environmental risk factors associated with juvenile idiopathic arthritis associated uveitis: a systematic review of the literature"

Sarah L N Clarke^*, Katie S Mageean, Henry Carlton, Gabriele Simonini, Gemma C Sharp, Caroline L Relton, Athimalaipet V Ramanan

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

BACKGROUND: Juvenile idiopathic arthritis associated uveitis (JIA-U) is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA) and carries considerable risk to vision. The aim of this systematic review was to synthesise evidence of environmental risk factors for JIA-U and identify risk factors which may be modifiable or used to stratify JIA patients.

METHODS: This systematic review was carried out in accordance with PRISMA guidelines. Four online databases - Cumulative Index of Nursing and Allied Health Literature, Web of Science, MEDLINE and Embase - were searched from database inception to 12th August 2020. Identified studies were screened by two independent reviewers against pre-defined inclusion and exclusion criteria. Data was extracted from all primary studies meeting inclusion criteria and independently checked.

RESULTS: We identified three studies from 895 unique records which met the inclusion criteria, each examining a different environmental risk factor. This systematic review includes 973, predominantly female, participants with JIA across these three studies. The use of allergy medication or documentation of "allergy"/"allergic" in the medical records was associated with an increased risk of JIA-U in all models presented. Vitamin D sufficiency was associated with reduced risk of JIA-U. There was insufficient evidence to support an association between seasonality and JIA-U.

CONCLUSIONS: This review identifies a potential role for allergy and vitamin D in JIA-U. It also illustrates the paucity of data regarding environmental risk factors for JIA-U and highlights the need for further research to both identify additional risk factors and replicate existing findings.

Original language	English
Article number	15
Number of pages	9
Journal	Journal of ophthalmic inflammation and infection
Volume	11
Issue number	1
DOIs	https://doi.org/10.1186/s12348-021-00247-1
Publication status	Published - 24 May 2021

Bibliographical note

Funding Information:
The authors wish to acknowledge Catherine Borwick (Information Specialist, University of Bristol) for her assistance during the design of search strategies for this review.

Funding Information:
This research was funded in whole, or in part, by the Wellcome Trust [203918/Z/16/Z to SLNC]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

Funding Information:
This work is also supported by the Medical Research Council and the University of Bristol [MC_UU_00011/5 to CLR]. The funders had no input in the protocol design or the undertaking of this systematic review.

Publisher Copyright:
© 2021, The Author(s).

Keywords

Juvenile idiopathic arthritis
Uveitis
Risk factors
Environment
Vitamin D
Season
Allergy

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10.1186/s12348-021-00247-1

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Final published version, 649 KBLicence: CC BY

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@article{6338ad1a3cef4528a47d7b32cd8e60c4,

title = "{"}Environmental risk factors associated with juvenile idiopathic arthritis associated uveitis: a systematic review of the literature{"}",

abstract = "BACKGROUND: Juvenile idiopathic arthritis associated uveitis (JIA-U) is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA) and carries considerable risk to vision. The aim of this systematic review was to synthesise evidence of environmental risk factors for JIA-U and identify risk factors which may be modifiable or used to stratify JIA patients.METHODS: This systematic review was carried out in accordance with PRISMA guidelines. Four online databases - Cumulative Index of Nursing and Allied Health Literature, Web of Science, MEDLINE and Embase - were searched from database inception to 12th August 2020. Identified studies were screened by two independent reviewers against pre-defined inclusion and exclusion criteria. Data was extracted from all primary studies meeting inclusion criteria and independently checked.RESULTS: We identified three studies from 895 unique records which met the inclusion criteria, each examining a different environmental risk factor. This systematic review includes 973, predominantly female, participants with JIA across these three studies. The use of allergy medication or documentation of {"}allergy{"}/{"}allergic{"} in the medical records was associated with an increased risk of JIA-U in all models presented. Vitamin D sufficiency was associated with reduced risk of JIA-U. There was insufficient evidence to support an association between seasonality and JIA-U.CONCLUSIONS: This review identifies a potential role for allergy and vitamin D in JIA-U. It also illustrates the paucity of data regarding environmental risk factors for JIA-U and highlights the need for further research to both identify additional risk factors and replicate existing findings.",

keywords = "Juvenile idiopathic arthritis, Uveitis, Risk factors, Environment, Vitamin D, Season, Allergy",

author = "Clarke, {Sarah L N} and Mageean, {Katie S} and Henry Carlton and Gabriele Simonini and Sharp, {Gemma C} and Relton, {Caroline L} and Ramanan, {Athimalaipet V}",

note = "Funding Information: The authors wish to acknowledge Catherine Borwick (Information Specialist, University of Bristol) for her assistance during the design of search strategies for this review. Funding Information: This research was funded in whole, or in part, by the Wellcome Trust [203918/Z/16/Z to SLNC]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Funding Information: This work is also supported by the Medical Research Council and the University of Bristol [MC_UU_00011/5 to CLR]. The funders had no input in the protocol design or the undertaking of this systematic review. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = may,

day = "24",

doi = "10.1186/s12348-021-00247-1",

language = "English",

volume = "11",

journal = "Journal of ophthalmic inflammation and infection",

issn = "1869-5760",

publisher = "SpringerOpen",

number = "1",

}

TY - JOUR

T1 - "Environmental risk factors associated with juvenile idiopathic arthritis associated uveitis

T2 - a systematic review of the literature"

AU - Clarke, Sarah L N

AU - Mageean, Katie S

AU - Carlton, Henry

AU - Simonini, Gabriele

AU - Sharp, Gemma C

AU - Relton, Caroline L

AU - Ramanan, Athimalaipet V

N1 - Funding Information: The authors wish to acknowledge Catherine Borwick (Information Specialist, University of Bristol) for her assistance during the design of search strategies for this review. Funding Information: This research was funded in whole, or in part, by the Wellcome Trust [203918/Z/16/Z to SLNC]. For the purpose of Open Access, the author has applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. Funding Information: This work is also supported by the Medical Research Council and the University of Bristol [MC_UU_00011/5 to CLR]. The funders had no input in the protocol design or the undertaking of this systematic review. Publisher Copyright: © 2021, The Author(s).

PY - 2021/5/24

Y1 - 2021/5/24

N2 - BACKGROUND: Juvenile idiopathic arthritis associated uveitis (JIA-U) is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA) and carries considerable risk to vision. The aim of this systematic review was to synthesise evidence of environmental risk factors for JIA-U and identify risk factors which may be modifiable or used to stratify JIA patients.METHODS: This systematic review was carried out in accordance with PRISMA guidelines. Four online databases - Cumulative Index of Nursing and Allied Health Literature, Web of Science, MEDLINE and Embase - were searched from database inception to 12th August 2020. Identified studies were screened by two independent reviewers against pre-defined inclusion and exclusion criteria. Data was extracted from all primary studies meeting inclusion criteria and independently checked.RESULTS: We identified three studies from 895 unique records which met the inclusion criteria, each examining a different environmental risk factor. This systematic review includes 973, predominantly female, participants with JIA across these three studies. The use of allergy medication or documentation of "allergy"/"allergic" in the medical records was associated with an increased risk of JIA-U in all models presented. Vitamin D sufficiency was associated with reduced risk of JIA-U. There was insufficient evidence to support an association between seasonality and JIA-U.CONCLUSIONS: This review identifies a potential role for allergy and vitamin D in JIA-U. It also illustrates the paucity of data regarding environmental risk factors for JIA-U and highlights the need for further research to both identify additional risk factors and replicate existing findings.

AB - BACKGROUND: Juvenile idiopathic arthritis associated uveitis (JIA-U) is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA) and carries considerable risk to vision. The aim of this systematic review was to synthesise evidence of environmental risk factors for JIA-U and identify risk factors which may be modifiable or used to stratify JIA patients.METHODS: This systematic review was carried out in accordance with PRISMA guidelines. Four online databases - Cumulative Index of Nursing and Allied Health Literature, Web of Science, MEDLINE and Embase - were searched from database inception to 12th August 2020. Identified studies were screened by two independent reviewers against pre-defined inclusion and exclusion criteria. Data was extracted from all primary studies meeting inclusion criteria and independently checked.RESULTS: We identified three studies from 895 unique records which met the inclusion criteria, each examining a different environmental risk factor. This systematic review includes 973, predominantly female, participants with JIA across these three studies. The use of allergy medication or documentation of "allergy"/"allergic" in the medical records was associated with an increased risk of JIA-U in all models presented. Vitamin D sufficiency was associated with reduced risk of JIA-U. There was insufficient evidence to support an association between seasonality and JIA-U.CONCLUSIONS: This review identifies a potential role for allergy and vitamin D in JIA-U. It also illustrates the paucity of data regarding environmental risk factors for JIA-U and highlights the need for further research to both identify additional risk factors and replicate existing findings.

KW - Juvenile idiopathic arthritis

KW - Uveitis

KW - Risk factors

KW - Environment

KW - Vitamin D

KW - Season

KW - Allergy

U2 - 10.1186/s12348-021-00247-1

DO - 10.1186/s12348-021-00247-1

M3 - Article (Academic Journal)

C2 - 34027581

SN - 1869-5760

VL - 11

JO - Journal of ophthalmic inflammation and infection

JF - Journal of ophthalmic inflammation and infection

IS - 1

M1 - 15

ER -

"Environmental risk factors associated with juvenile idiopathic arthritis associated uveitis: a systematic review of the literature"

Abstract

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