Frontiers in pediatrics · 2026
Exploratory analysis of neutrophil extracellular traps in synovial fluid and plasma from children with juvenile idiopathic arthritis.
СтатьяНазвание и аннотация: Перевод в очереди
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Berntson Lillemor, Sandström Caroline, Elfving Andreas, Mobarrez Fariborz
Аннотация
BACKGROUND: The innate immune system is increasingly recognised as a key driver in the pathogenesis of juvenile idiopathic arthritis (JIA). Extracellular vesicles (EVs) have emerged as important mediators of inflammation, potentially reflecting cellular activation and disease processes in vivo. The aim of this exploratory pilot study was to investigate the presence of neutrophil- and platelet-derived EVs in the plasma and synovial fluid of children with JIA and compare these with plasma levels in healthy controls.
METHODS: Seven children with active, untreated JIA and ten healthy controls were included. Citrate plasma and synovial fluid were analysed for neutrophil- and platelet-derived EVs using flow cytometry. Disease activity was assessed using the Juvenile Arthritis Disease Activity Score (JADAS27) and functional impairment via the Childhood Health Assessment Questionnaire (CHAQ). Non-parametric tests were used in analyses.
RESULTS: Neutrophil- and platelet-associated EVs were detectable not only in plasma but also in synovial fluid in all children with JIA. Plasma levels of CD41+ EVs and MPO+ EVs were significantly higher in the JIA group compared with controls. Activated platelet EVs (CD41+ and CD41 + CD62P) were detected predominantly in plasma and only at low levels in synovial fluid. MPO+ and H3Cit+ EVs were present in both compartments, indicating neutrophil activation and NET-related components. No correlations between EV levels and clinical or laboratory variables were found.
CONCLUSION: This exploratory pilot study is the first to assess platelet- and neutrophil/NET-associated EV phenotypes in both plasma and synovial fluid in children with JIA. The results indicate systemic platelet activation and NET-related activity in both circulation and the inflamed joint compartment.
METHODS: Seven children with active, untreated JIA and ten healthy controls were included. Citrate plasma and synovial fluid were analysed for neutrophil- and platelet-derived EVs using flow cytometry. Disease activity was assessed using the Juvenile Arthritis Disease Activity Score (JADAS27) and functional impairment via the Childhood Health Assessment Questionnaire (CHAQ). Non-parametric tests were used in analyses.
RESULTS: Neutrophil- and platelet-associated EVs were detectable not only in plasma but also in synovial fluid in all children with JIA. Plasma levels of CD41+ EVs and MPO+ EVs were significantly higher in the JIA group compared with controls. Activated platelet EVs (CD41+ and CD41 + CD62P) were detected predominantly in plasma and only at low levels in synovial fluid. MPO+ and H3Cit+ EVs were present in both compartments, indicating neutrophil activation and NET-related components. No correlations between EV levels and clinical or laboratory variables were found.
CONCLUSION: This exploratory pilot study is the first to assess platelet- and neutrophil/NET-associated EV phenotypes in both plasma and synovial fluid in children with JIA. The results indicate systemic platelet activation and NET-related activity in both circulation and the inflamed joint compartment.