Advancements in Diagnosis and Care for Immune Dysregulation and Inborn Errors of Immunity in Pediatric Rheumatology: Our 50-Year Journey.

Caring for children with complex immune disorders is part of the heritage of pediatric rheumatology that extends back to the original founders of the field. Over the past 50 years, pediatric rheumatologists have been central to advancing discovery and pioneering innovative treatment approaches for pediatric patients with multifaceted immune dysfunction. This includes dissecting disease mechanisms and identifying novel genes associated with inflammasome activation, IL-18 opathies, type I interferonopathies, monogenic mosaic disorders, and other forms of immune dysregulation. Pediatric rheumatologists have made foundational contributions to the management of patients with these conditions by leveraging their expertise in existing immunomodulatory medications and recognizing new drug targets. In the next 50 years, scientists and clinicians in the field are poised to make substantial innovations in understanding the causes and biomarkers of immune dysregulation. By harnessing the power of precision medicine, cellular therapies, and immune multidisciplinary teams, pediatric rheumatologists will continue to drive discoveries that will improve outcomes for patients with immune dysregulation.