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PostPosted: Tue Aug 11, 2015 11:01 am 
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Overuse of antibiotics tied to double the risk of juvenile arthritis in study
By David Gutierrez
juvenile arthritis, antibiotics, childhood disease


Taking antibiotics may make children twice as likely to develop juvenile arthritis, suggests a study conducted by researchers from Rutgers University, the University of Pennsylvania and Nemours A.I. duPont Hospital for Children, and published in the journal Pediatrics.

"Our research suggests another possible reason to avoid antibiotic overuse for infections that would otherwise get better on their own," lead author Daniel Horton said.

Juvenile idiopathic arthritis (JIA) is an umbrella term used to describe various forms of chronic arthritis that begin before the age of 16, lasting for at least six weeks. JIA is an autoimmune disorder that can involve not just inflammation of the joints but also of the eyes. It can also cause fever and rash, and can lead to pain, disability and even blindness.

Disrupting the microbiome

According to the U.S. Centers for Disease Control and Prevention, up to 9,700 new cases of JIA are diagnosed each year. But studies have shown that genetics only explains about 25 percent of the risk of developing JIA, suggesting a hefty environmental component to the disease.

Previous studies have shown that other autoimmune diseases might be connected to disruption of the microbiome - the ecological community of microorganisms that inhabit the human gut, skin, mouth and other parts of the body. The microbiome is increasingly being shown to play critical roles in health, including in regulating the immune system. Disruption of the microbiome has been linked to the autoimmune disorder inflammatory bowel disease (IBD) and rheumatoid arthritis (which shares many characteristics with JIA, but occurs in adults).

Consistent with these findings, other studies have shown that early antibiotic use may raise the risk of chronic diseases including IBD.

"Antibiotics are one of the better known disruptors of human microbial communities," Horton said.

Dangers of overprescribing

To see if early antibiotic use affected JIA risk, the researchers studied 450,000 children contained in The Health Improvement Network database, which records high-quality data on diagnoses and prescriptions in Britain. From this sample, 152 children with JIA were identified, excluding children with prior diagnosis of IBD, immunodeficiency, vasculitis or autoimmune connective tissue disease. These children were compared with a control group from within the same database, matched by age and gender. All children included in the study had been registered with the database within three months of birth, so that a nearly complete health history was available for the researchers.

The researchers found that after adjusting for differences caused by prior infections, children who had been prescribed antibiotics were twice as likely to develop JIA by age 16 as children of a similar age and gender who had never received antibiotics. The risk of developing JIA was highest within one year of taking antibiotics, and increased with the number of antibiotic courses taken. The risk was independent, however, of the number or type of infections suffered by the child, or of the age at which children were exposed to the drugs.

Different classes of antibiotics all seemed to produce similar increases in risk. Antiviral and antifungal drugs, however, had no effect on JIA risk.

Statistical analysis ruled out the possibility that children taking more antibiotics simply had their JIA diagnosed sooner, confirming that they did indeed have higher rates of the disease.

While the study was not set up to prove that antibiotics directly cause higher rates of JIA, it does provide cause for caution - especially since, according to other studies, about a quarter of all antibiotic prescriptions written for children are unnecessary. Among prescriptions for acute respiratory infections, half are unnecessary.

"This is an extremely important clue about the etiology of this serious and potentially crippling disease," senior author Brian Strom said. "If confirmed, it also provides a means for preventing it."


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PostPosted: Tue Aug 11, 2015 11:09 am 

Joined: Sun Feb 22, 2015 9:43 am
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