"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 journalArticle (Academic Journal)peer-review

4 Citations (Scopus)
66 Downloads (Pure)

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 languageEnglish
Article number15
Number of pages9
JournalJournal of ophthalmic inflammation and infection
Volume11
Issue number1
DOIs
Publication statusPublished - 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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