Causal link between physical activity and juvenile idiopathic arthritis through inflammatory cytokines
Abstract
Objective: This study aims to investigate the causal relationship between physical activity and Juvenile Idiopathic Arthritis (JIA) using Mendelian Randomisation (MR), with a particular focus on the regulatory mechanisms of inflammatory factors SCGF-beta, IP-10, and IFN-lambda 2. This abstract seeks to elucidate these biological relationships and provide a foundation for future therapeutic strategies. Methods: We employed Mendelian randomisation techniques to assess the impact of physical exercise on SCGF-beta, IP-10, and IFN-lambda 2. Data were sourced from genome-wide association studies (GWAS) for these inflammatory markers. Causal estimates were determined using MR Egger, weighted median, and inverse variance weighting (IVW) methods. Sensitivity analyses, encompassing heterogeneity and pleiotropy tests, were also conducted. Results: Significant correlations were identified between physical activity and the inflammatory factors. For SCGF-beta, MR-Egger (P = 1.22 × 10−6, Beta = 0.5201), weighted median (Beta = 37.1429), and IVW (Beta = 103.9579) all indicated associations. For IP-10, MR-Egger (P = 0.387298409, Beta = 15.79010798), weighted median (Beta = 0.0415), and IVW (Beta = 0.3287) showed similar outcomes. For IFN-lambda 2, MR-Egger (P = 0.0018, Beta = 0.7464), weighted median (Beta = 1.0033), and IVW (Beta = 0.4616) highlighted significant associations. Conclusion: This MR study suggests that physical activity may causally influence JIA by modulating inflammatory factors such as SCGF-beta, IP-10, and IFN-lambda 2. These findings point to physical activity as a potential intervention for JIA. Further research is needed to confirm these results and explore the underlying mechanisms. (1) This study identifies a significant impact of physical activity on the risk of juvenile idiopathic arthritis by modulating inflammatory cytokines, including SCGF-beta, IP-10, and IFN-lambda 2. (2) Through Mendelian randomisation analysis, this research underscores the potential of physical activity as a non-pharmacological intervention for reducing the risk of chronic inflammatory diseases.
References
1. Woolnough, Leandra U, Lentini, Logan, Sharififar, Sharareh, Chen, Cong, Vincent, Heather K, (2022). The relationships of kinesiophobia and physical function and physical activity level in juvenile idiopathic arthritis. Pediatric rheumatology online journal, 20 (1), 73. https://doi.org/10.1186/s12969-022-00734-2
2. Gil, Elisabeth G, Skeie, Marit S, Halbig, Josefine, Jönsson, Birgitta, Lie, Stein Atle, Rygg, Marite, Fischer, Johannes, Rosén, Annika, Bletsa, Athanasia, Luukko, Keijo, Shi, Xie-Qi, Frid, Paula, Cetrelli, Lena, Tylleskär, Karin, Rosendahl, Karen, Åstrøm, Anne N, (2022). Oral health-related quality of life in 4-16-year-olds with and without juvenile idiopathic arthritis. BMC oral health, 22 (1), 387. https://doi.org/10.1186/s12903-022-02400-1
3. Vincent, Heather K, Sharififar, Sharareh, Abdelmalik, Bishoy, Lentini, Logan, Chen, Cong, Woolnough, Leandra U, (2022). Gait parameters, functional performance and physical activity in active and inactive Juvenile Idiopathic Arthritis. GAIT & POSTURE, 98 226-232. https://doi.org/10.1016/j.gaitpost.2022.09.080
4. Holovko, T. O., Shevchenko, N. S., Bohmat, L. F., Nikonova, V. V., (2022). Tolerance to exercise in adolescents with rheumatic diseases taking into account systolic heart function Pathologia, 19 (1), 18-23. https://doi.org/10.14739/2310-1237.2022.1.243693
5. Miladi, S, Bouzid, S, Fazaa, A, Souabni, L, Sellami, M, Ouenniche, K, Kassab, S, Chekili, S, Ben Abdelghani, K, Laatar, A, (2021). P019 Adulthood of juvenile idiopathic arthritis patients: professional outcome RHEUMATOLOGY, 60 (Supple5), https://doi.org/10.1093/rheumatology/keab722.011
6. Ozdemir, Berk Can, Savci, Sema, Tanriverdi, Aylin, Ozcan Kahraman, Buse, Isguder, Rana, Makay, Balahan, Unsal, Erbil, (2023). Determinants of physical activity level in children and adolescents with juvenile idiopathic arthritis. Zeitschrift fur rheumatologie, 83 (Suppl 1), 71-77. https://doi.org/10.1007/s00393-023-01340-7
7. Craig, Joshua, Feldman, Brian M, Spiegel, Lynn, Dover, Saunya, (2020). Comparing the Measurement Properties and Preferability of Patient-reported Outcome Measures in Pediatric Rheumatology: PROMIS vs CHAQ. Journal of rheumatology, 48 (7), 1065-1072. https://doi.org/10.3899/jrheum.200943
8. Oliveira Ramos, Filipa, Rodrigues, Ana, Magalhaes Martins, Fernando, Melo, Ana Teresa, Aguiar, Francisca, Brites, Luisa, Azevedo, Soraia, Duarte, Ana Catarina, Furtado, Carolina, Mourão, Ana Filipa, Sequeira, Graça, Cunha, Inês, Figueira, Ricardo, Melo Gomes, Jose Antonio, Santos, Maria Jose, Fonseca, Joao Eurico, (2021). Health-related quality of life and disability in adults with juvenile idiopathic arthritis: comparison with adult-onset rheumatic diseases. RMD open, 7 (3), https://doi.org/10.1136/rmdopen-2021-001766
9. Ferjani, Hanene Lassoued, Makhlouf, Yasmine, Ben Ammar, Lobna, Triki, Wafa, Ben Nessib, Dorra, Maatallah, Kaouther, Kaffel, Dhia, Hamdi, Wafa, (2022). 06 Flat foot impairs physical activity in children with juvenile idiopathic arthritis RHEUMATOLOGY, 61 (Supple2), https://doi.org/10.1093/rheumatology/keac496.002
10. Schujovitzky, Dana, Ziv, Amit, Heshin Bekenstein, Merav, Eylon, Sharon, Grossman, Zachi, Hashkes, Philip J, Uziel, Yosef, Haviv, Ruby, (2022). Measuring the knowledge of juvenile idiopathic arthritis among Israeli paediatricians and paediatric orthopaedic surgeons: what needs to be improved? Clinical and experimental rheumatology, 40 (11), 2188-2193. https://doi.org/10.55563/clinexprheumatol/7j9es3
11. Codes-Mendez, H., Magallares, B., Martínez-Martínez, L., Park, H., Lobo Prat, D., Sainz Comas, L., Gich, I., Alvaro, Y., Molto, E., Calahorro, V., Boronat, S., Corominas, H., (2022). AB1237 Comparison between enzyme immunoassay and chemiluminescence to determine the concentration of serum calprotectin and its association with clinical variables in pediatric rheumatology. annals of the rheumatic diseases, 81 (Suppl 1), 1730-1731. https://doi.org/10.1136/annrheumdis-2022-eular.1892
12. Polat, Merve Cansu, Çelikel, Elif, Tekin, Zahide Ekici, Güngörer, Vildan, Kurt, Tuba, Tekgöz, Nilüfer, Sezer, Müge, Karagöl, Cüneyt, Coşkun, Serkan, Kaplan, Melike Mehveş, Öner, Nimet, Acar, Banu Çelikel, (2023). Assessment of quality of life and physical activity in patients with oligoarticular juvenile idiopathic arthritis in remission. EUROPEAN JOURNAL OF PEDIATRICS, 183 (2), 955-964. https://doi.org/10.1007/s00431-023-05367-5
13. Fazaa, A., Kammoun, M., Miladi, S., Boussaa, H., Ouenniche, K., Souabni, L., Kassab, S., Chekili, S., Ben Abdelghani, K., Laatar, A., (2022). Ab0154 physical function assessment tools in patients with juvenile idiopathic arthritis: jafas versus chaq annals of the rheumatic diseases, 81 (Suppl 1), 1207.2-1208. https://doi.org/10.1136/annrheumdis-2022-eular.3975
14. Nascimento Leite, Mariana, Kamper, Steven J, O’Connell, Neil E, Michaleff, Zoe A, Fisher, Emma, Viana Silva, Priscilla, Williams, Christopher M, Yamato, Tiê P, (2023). Physical activity and education about physical activity for chronic musculoskeletal pain in children and adolescents. The Cochrane database of systematic reviews, 7 CD013527. https://doi.org/10.1002/14651858.CD013527.pub2
15. Triki, W., Dghaies, A., Ferjani, H., Ben Aissa, R., Ben Nessib, D., Maatallah, K., Kaffel, D., Hamdi, W., (2022). AB1255 Assessment of sleep disturbances in children with juvenile idiopathic arthritis annals of the rheumatic diseases, 81 (Suppl 1), 1737.3-1738. https://doi.org/10.1136/annrheumdis-2022-eular.3731
16. Kuntze, Gregor, Nettel-Aguirre, Alberto, Brooks, Julia, Esau, Shane, Nesbitt, Colleen, Mosher, Dianne, Twilt, Marinka, Benseler, Susanne, Ronsky, Janet L, Emery, Carolyn A, (2021). Vertical Drop Jump Performance in Youth With Juvenile Idiopathic Arthritis. Arthritis care & research, 73 (7), 955-963. https://doi.org/10.1002/acr.24219
17. Kozu, Kátia T, Casella, Caio B, Strabelli, Claudia A A, Aikawa, Nadia E, Campos, Lucia M A, Elias, Adriana M, Miguel, Eurípedes C, Polanczyk, Guilherme V, Silva, Clovis A, (2022). Mental Health Impact in Latin American Pediatric Rheumatologists During the COVID-19 Pandemic. Jcr-journal of clinical rheumatology, 28 (2), e506-e510. https://doi.org/10.1097/RHU.0000000000001782
18. Ben Ouahma, B, Triki, W, Maatallah, K, Ferjani, H, Ben Nessib, D, Kaffel, D, Hamdi, W, (2021). P027 Assessment of physical activity in Juvenile Idiopathic Arthritis Rheumatology, 60 (Supple5), https://doi.org/10.1093/rheumatology/keab722.019
19. Oliveira Ramos, Filipa, Rodrigues, Ana Maria, Melo, Ana Teresa, Aguiar, Francisca, Brites, Luísa, Azevedo, Soraia, Duarte, Ana Catarina, Gomes, José António Melo, Furtado, Carolina, Mourão, Ana Filipa, Sequeira, Graça, Cunha, Inês, Figueira, Ricardo, Santos, Maria José, Fonseca, João Eurico, (2023). Influence of the timing of biological treatment initiation on Juvenile Idiopathic Arthritis long-term outcomes. Arthritis research & therapy, 25 (1), 177. https://doi.org/10.1186/s13075-023-03166-9
20. Dzhus, M., Kulyk, M., Karasevska, T., (2022). POS1315 Prevalence of sarcopenia in young adults with juvenile idiopathic arthritis annals of the rheumatic diseases, 81 (Suppl 1), 995.1-995. https://doi.org/10.1136/annrheumdis-2022-eular.3742
21. Elmesmari, Rabha A, Reilly, John J, Paton, James Y, (2022). 24-Hour Movement Behaviors in Children with Chronic Disease and Their Healthy Peers: A Case-Control Study. International journal of environmental research and public health, 19 (5), https://doi.org/10.3390/ijerph19052912
22. Jonyk, L, Sagawa Junior, Y, Tordi, N, Ballot Schmit, C, (2022). Description of physical activity in children with juvenile idiopathic arthritis using accelerometry. Archives de pediatrie, 30 (2), 83-88. https://doi.org/10.1016/j.arcped.2022.11.003
23. Phenoscanner: A GWAS database. Available online: http://www.phenoscanner.medschl.cam.ac.uk/ (accessed on 15 June 2024).
24. Grammatikopoulou, Maria G, Gkiouras, Konstantinos, Syrmou, Vasiliki, Vassilakou, Tonia, Simopoulou, Theodora, Katsiari, Chistina G, Goulis, Dimitrios G, Bogdanos, Dimitrios P, (2023). Nutritional Aspects of Juvenile Idiopathic Arthritis: An A to Z for Dietitians. Children (Basel, Switzerland), 10 (2), https://doi.org/10.3390/children10020203
25. Di Marcello, Francesca, Di Donato, Giulia, d’Angelo, Debora Mariarita, Breda, Luciana, Chiarelli, Francesco, (2022). Bone Health in Children with Rheumatic Disorders: Focus on Molecular Mechanisms, Diagnosis, and Management. International journal of molecular sciences, 23 (10), https://doi.org/10.3390/ijms23105725
26. Halbig, Josefine M, Jönsson, Birgitta, Gil, Elisabeth G, Åstrøm, Anne N, Rypdal, Veronika, Frid, Paula, Augdal, Thomas A, Fischer, Johannes, Cetrelli, Lena, Rygg, Marite, Lundestad, Anette, Tylleskär, Karin, Nordal, Ellen, (2023). Oral health-related quality of life, impaired physical health and orofacial pain in children and adolescents with juvenile idiopathic arthritis - a prospective multicenter cohort study. BMC oral health, 23 (1), 895. https://doi.org/10.1186/s12903-023-03510-0
27. Py, Stéphanie, Maylié, Florine, Parmentier, Anne-Laure, Vidal, Chrystelle, Cuinet, Benjamin, Mauny, Fréderic, Lohse, Anne, Toussirot, Eric, Yoshimasa, Sagawa, Tordi, Nicolas, Binda, Delphine, Ballot-Schmit, Claire, (2023). ATHLETIQUE: interest of an adapted physical activity program in patients with juvenile idiopathic arthritis: a feasibility and preliminary effectiveness study. Frontiers in immunology, 14 1213799. https://doi.org/10.3389/fimmu.2023.1213799
28. Skorpen, C., Lydersen, S., Salvesen, K. Å., Wallenius, M., (2023). Pos0774 cesarean section in women with juvenile idiopathic arthritis – a population-based study annals of the rheumatic diseases, 82 (Suppl 1), 679.1-679. https://doi.org/10.1136/annrheumdis-2023-eular.5350
29. Bingham, Catherine A, Harris, Julia G, Qiu, Tingting, Gilbert, Mileka, Vora, Sheetal S, Yildirim-Toruner, Cagri, Ferraro, Kerry, Lovell, Daniel J, Taylor, Janalee, Mannion, Melissa L, Weiss, Jennifer E, Laxer, Ronald M, Shishov, Michael, Oberle, Edward J, Gottlieb, Beth S, Lee, Tzielan C, Pan, Nancy, Burnham, Jon M, Fair, Danielle C, Batthish, Michelle, Hazen, Melissa M, Spencer, Charles H, Morgan, Esi M, (2023). Pediatric Rheumatology Care and Outcomes Improvement Network’s Quality Measure Set to Improve Care of Children With Juvenile Idiopathic Arthritis. ARTHRITIS CARE & RESEARCH, 75 (12), 2442-2452. https://doi.org/10.1002/acr.25168
30. Gruca, M., Orczyk, K., Zamojska, J., Niewiadomska-Jarosik, K., Stanczyk, J., Smolewska, E., (2022). POS1317 How can we assess cardiovascular risk in patients with juvenile idiopathic arthritis? preliminary results regarding measurements of carotid intima-media thickness during the COVID-19 pandemic. Annals of the rheumatic diseases, 81 (Suppl 1), 995.3-996. https://doi.org/10.1136/annrheumdis-2022-eular.3802
31. Tollisen, Anita, Selvaag, Anne M, Aasland, Astrid, Ingebrigtsen, Trude, Sagen, Joachim, Lerdal, Anners, Flatø, Berit, (2022). Personally Generated Quality of Life Outcomes in Adults With Juvenile Idiopathic Arthritis. Journal of rheumatology, 49 (10), 1138-1145. https://doi.org/10.3899/jrheum.211245
32. Räsänen, Kati, Markula-Patjas, Kati, Kantanen, Saija, Sipilä, Kalle, Lakka, Timo A, Arikoski, Pekka, Piippo-Savolainen, Eija, (2023). Impaired cardiorespiratory and neuromuscular fitness in children and adolescents with juvenile idiopathic arthritis: a cross-sectional case-control study in the era of biologic drug therapies. Pediatric rheumatology online journal, 21 (1), 26. https://doi.org/10.1186/s12969-023-00808-9
33. de Oliveira, Rodrigo Joel, Londe, Ana Carolina, de Souza, Débora Pessoa, Marini, Roberto, Fernandes, Paula Teixeira, Appenzeller, Simone, (2023). Physical Activity Influences Health-Related Quality of Life in Adults with Juvenile Idiopathic Arthritis. Journal of clinical medicine, 12 (3), https://doi.org/10.3390/jcm12030771
34. Sabounji, Mounib M, Ndiaye, Aïssatou, Niasse, Moustapha, Abba, Abbasse, Gueye, Aminata, Diallo, Saïdou, (2021). O001. Juvenile-onset spondyloarthritis: a study of 54 cases in Senegal RHEUMATOLOGY, 60 (Supple5), https://doi.org/10.1093/rheumatology/keab723
35. Bohmat, L., Shevchenko, N., Fadieieva, A., Nikonova, V., (2022). POS1542-HPR Quality of life and physical functioning of patients with juvenile idiopathic arthritis fast translate icon translate fast translate icon translate annals of the rheumatic diseases, 81 (Suppl 1), 1115.3-1116. https://doi.org/10.1136/annrheumdis-2022-eular.5105
36. Gupta, Umesh Chandra, Gupta, Subhas Chandra, Gupta, Saira Sugandh, (2022). Clinical Overview of Arthritis with a Focus on Management Options and Preventive Lifestyle Measures for Its Control Current Nutrition & Food Science, 18 https://doi.org/10.2174/1573401318666220204095629
37. Rochette, Emmanuelle, Saidi, Oussama, Merlin, Étienne, Duché, Pascale, (2023). Physical activity as a promising alternative for young people with juvenile idiopathic arthritis: Towards an evidence-based prescription. Frontiers in immunology, 14 1119930. https://doi.org/10.3389/fimmu.2023.1119930
38. Gorczyca, Daiva, Iwańczyk, Patrycja, Staś, Karolina, Postępski, Jacek, (2023). Knee pain as a reason for referral to a paediatric rheumatologist: A retrospective study. Journal of paediatrics and child health, 59 (3), 439-444. https://doi.org/10.1111/jpc.16309
39. Kuntze, Gregor, Nettel-Aguirre, Alberto, Brooks, Julia, Esau, Shane, Nesbitt, Colleen, Mosher, Dianne, Twilt, Marinka, Benseler, Susanne, Ronsky, Janet L, Emery, Carolyn A, (2021). Consequences of Juvenile Idiopathic Arthritis on Single Leg Squat Performance in Youth. Arthritis care & research, 73 (8), 1187-1193. https://doi.org/10.1002/acr.24254
40. Butler, Sonia, Sculley, Dean, Santos, Derek, Fellas, Antoni, Gironès, Xavier, Singh-Grewal, Davinder, Coda, Andrea, (2022). Effectiveness of eHealth and mHealth Interventions Supporting Children and Young People Living With Juvenile Idiopathic Arthritis: Systematic Review and Meta-analysis. Journal of medical Internet research, 24 (2), e30457. https://doi.org/10.2196/30457
41. Milatz, Florian, Hansmann, Sandra, Klotsche, Jens, Niewerth, Martina, Kallinich, Tilmann, Dressler, Frank, Haas, Johannes-Peter, Berendes, Rainer, Horneff, Gerd, Hufnagel, Markus, Weller-Heinemann, Frank, Windschall, Daniel, Trauzeddel, Ralf, Klaas, Moritz, Girschick, Hermann, Oommen, Prasad T, Foeldvari, Ivan, Cantez, Serdar Mustafa, Jansson, Annette F, Hartmann, Matthias, Peitz-Kornbrust, Joachim, Minden, Kirsten, (2024). Level and correlates of physical activity among children and adolescents with juvenile idiopathic arthritis compared to controls: results from a German nationwide prospective observational cohort study. Pediatric rheumatology online journal, 22 (1), 39. https://doi.org/10.1186/s12969-024-00976-2
42. Trachtman, Rebecca, Samuels, Julie, Wojtal, Emma, Feldman, Brian M, (2023). Resilience and its associations in children with Systemic Lupus Erythematosus and Juvenile Idiopathic Arthritis. Pediatric rheumatology online journal, 21 (1), 67. https://doi.org/10.1186/s12969-023-00854-3
43. Alongi, Alessandra, Giancane, Gabriella, Naddei, Roberta, Natoli, Valentina, Ridella, Francesca, Burrone, Marco, Rosina, Silvia, Chedeville, Gaelle, Alexeeva, Ekaterina, Horneff, Gerd, Foeldvari, Ivan, Filocamo, Giovanni, Constantin, Tamàs, Ruperto, Nicolino, Ravelli, Angelo, Consolaro, Alessandro, (2022). Drivers of non-zero physician global scores during periods of inactive disease in juvenile idiopathic arthritis. RMD open, 8 (1), https://doi.org/10.1136/rmdopen-2021-002042
44. Zare, Najmeh, Mansoubi, Maedeh, Coe, Shelly, Najafi, Ali Aminalsharieh, Bailey, Kathryn, Harrison, Kathryn, Sheehan, Joanna, Dawes, Helen, Barker, Karen, (2023). An investigation into the relationship between nutritional status, dietary intake, symptoms and health-related quality of life in children and young people with juvenile idiopathic arthritis: a systematic review and meta-analysis. BMC pediatrics, 23 (1), 3. https://doi.org/10.1186/s12887-022-03810-4
45. Yücel, Aylin, Aydog, Ozlem, Karadavut, Kıymet Ikbal, Uneri, Sukran Ozden, (2023). Evaluation of osteoporosis and related factors and quality of life of patients with juvenile idiopathic arthritis and burnout status of parents Journal of Surgery and Medicine, 7 (1), 26-30. https://doi.org/10.28982/josam.7556
46. Miyamae, Takako, Inoue, Eisuke, Tanaka, Eiichi, Kawabe, Tomohiro, Ikari, Katsunori, Harigai, Masayoshi, (2023). Association of disease activity using SDAI and DAS28, but not JADAS-27, with subsequent changes in physical function in adult patients with juvenile idiopathic arthritis. Modern Rheumatology, 33 (3), 588-593. https://doi.org/10.1093/mr/roac063
47. Bozcuk, S., Basakci Calik, B., Gur Kabul, E., Ekici Tekin, Z., Yuksel, S., (2022). AB1525-HPR Examination of physical fitness in children and adolescents with juvenile idiopathic arthritis: a comparative study annals of the rheumatic diseases, 81 (Suppl 1), 1865.1-1865. https://doi.org/10.1136/annrheumdis-2022-eular.2285
Copyright (c) 2025 Shuaiju Han, Ziyu Wang, Gang Qin, Mengyu Hao
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright on all articles published in this journal is retained by the author(s), while the author(s) grant the publisher as the original publisher to publish the article.
Articles published in this journal are licensed under a Creative Commons Attribution 4.0 International, which means they can be shared, adapted and distributed provided that the original published version is cited.