Enthesitis Related Arthritis (ERA) happens when the immune system, which normally attacks germs, mistakenly attacks the joints. This causes inflammation (swelling and irritation) in the joints and other problems in the body. Some children with ERA struggle with ongoing pain that affect their daily lives. Unfortunately, ERA does not have reliable tests to predict how a child will respond to treatment. This means doctors often must try different medications before finding the right one. We need better tools to help guide treatment decisions and track disease progression.

Our research focuses on using a cutting-edge approach called multi-omics, which looks at genes, proteins, and immune cells together to better understand diseases. This approach is beginning to advance research in conditions like rheumatoid arthritis and lupus, but it has not yet been used in ERA.

To change this, we are studying a group of children with newly diagnosed ERA. We are collecting blood samples when they are diagnosed and again 12 weeks after starting treatment. By analyzing these samples, we will study T cells, a type of immune cell, to see how they change with treatment. We will also measure changes in immune markers found in the blood to understand how the immune system responds to therapy.

We believe that children who respond well to treatment will show a shift in their immune cells—from an overactive, inflammatory state to a more balanced and controlled state. If we can identify these changes early, we may be able to predict which treatments will work best for each child.

Our study has two main goals: 1. Identify immune cell patterns that can serve as early warning signs of whether a child’s treatment is working. 2. Find changes in key molecules in the blood that are linked to disease activity and can help track improvement over time.

By combining this information with disease symptoms, we hope to create a predictive tool that can personalize treatment for children with ERA. This research will help improve care for kids with ERA and lay the foundation for targeted medicine approaches.

This project will also support my career as a researcher and physician, providing the training and mentorship I need to continue studying childhood autoimmune diseases. Our work aligns with CARRA’s mission to improve outcomes for children with arthritis through cutting-edge research.