Australian and New Zealand Childhood Arthritis Risk factor Identification Study (ANZ CLARITY)
- Project status: Active
Research area: Infection, Immunity and Global Health > Molecular Immunology
Establishing a national juvenile idiopathic arthritis (JIA) biobank, called ANZ-CLARITY (Australian and New Zealand childhood arthritis risk factor identification study).
The ANZCLARITY study is working to better understand the form of childhood arthritis called JIA in hopes of improving care, identifying cause, and eventually finding a cure.
The ANZCLARITY study is working to better understand the form of childhood arthritis called JIA in hopes of improving care, identifying cause, and eventually finding a cure.
Juvenile Idiopathic Arthritis (JIA) overview
Juvenile idiopathic arthritis (JIA) is an autoimmune disease. Normally, your immune system protects you from germs and keeps you healthy. In autoimmune conditions, the immune system mistakenly attacks healthy parts of the body as if they were foreign invaders.
In JIA, the immune system targets the joints and sometimes other tissues. This autoimmune process isn’t fully understood. Common symptoms include:
- Joint pain and swelling
- Stiffness (especially in the morning)
- Difficulty moving
- Occasional fevers and rash
There is currently no cure for JIA. Around 6,000 Australian children are affected by some form of childhood arthritis.
About the ANZ-CLARITY Biobank
The ANZ-CLARITY Biobank will collect body fluid samples, such as blood, saliva and synovial fluid (joint fluid), from children with and without JIA. It will also collect personal and health information from these children.
The biospecimens and personal and health information will be stored at the Murdoch Children’s Research Institute (MCRI) and used for research to better understand JIA and related conditions.
Juvenile arthritis research at MCRI
Watch Associate Professor Jane Munro & Associate Professor Justine Ellis outline CLARITY, the juvenile idiopathic arthritis biobank established between Murdoch Children’s Research Institute and The Royal Children's Hospital (RCH).
In 2008, researchers launched the Victorian JIA biobank CLARITY (Childhood Arthritis Risk Factor Identification study) to explore how genes and environmental factors influence the risk of developing juvenile idiopathic arthritis (JIA).
To increase participation, we’re now expanding the biobank nationally to include children and their families—both with and without JIA—from across Australia.
By creating a national JIA biobank, we have a greater chance of answering key questions:
- Why are some children more likely to develop JIA?
- Why do some children experience more severe illness than others?
- Why do treatments work for some but not for all?
In the long term, this research could lead to:
- New treatments
- Better prevention strategies
- Improved care for children and young people living with JIA
ANZ-CLARITY is working closely with researchers at the University of Sydney and partners nationwide to establish the Australian Arthritis and Autoimmune Biobank Collaborative (A3BC). This initiative collects data and biospecimens from both children and adults to advance arthritis research across all age groups.
Why is ANZ-CLARITY so important?
The Australian and New Zealand Childhood Arthritis Risk Factor Identification study (ANZ-CLARITY) is unique. It examines a child’s early life environment and genetic profile to:
- identify the reasons JIA occurs among Australian children
- improve knowledge on how to diagnose and treat JIA
- improve knowledge on how to prevent JIA.
We aim to involve thousands of Australian children—both with and without JIA—and their families. By comparing these groups, researchers can better understand the condition.
Participation involves:
- Collecting DNA (the genetic code that determines all characteristics of a living thing) through a blood or saliva sample
- Completing a questionnaire about the child’s environment
This research will help uncover the causes of JIA and pave the way for better treatments and prevention strategies.
More resources
- Information about Rheumatological conditions - The Royal Children's Hospital
- Juvenile idiopathic arthritis - Arthritis Australia
Information for participants
The success of this project depends on the generous contribution of children with and without JIA and their families. Each young person's information is valuable to the project and helps us better understand JIA. Thank you for your interest.
Consent form
If you want to be involved in the study, you will need to complete a parent/guardian consent form.
Saliva collection instructional video
This video shows how to use the Oragene.DNA OG-575 Assisted Collection Kit to collect DNA from saliva. Please note: geographic restrictions may apply.
Frequently asked questions
Research team
Jane Munro
Jane is a paediatric rheumatologist and Head of the Paediatric Rheumatology Unit at the Royal Children’s Hospital, Melbourne. She is the Principal Investigator of ANZ-CLARITY. She is passionate about conducting research that will improve the care of her patients. She loves working with children and young people and their families. She is also a mum to three kids who keep her on her toes, and she loves reading, planning events and trips, exercising and cooking.
National associate investigators
Peter Gowdie
Peter is a Paediatric Rheumatologist and General Paediatrician with appointments at both The Royal Children’s Hospital and Monash Children’s Hospital where he is the Head of Paediatric Rheumatology. Peter holds an Adjunct Lecturer appointment at Monash University, where he teaches undergraduate medical students. His teaching commitments also include the education of postgraduate rheumatology and paediatric specialist trainees.
Peter is actively involved in Rheumatology and General Paediatric research at The Royal Children’s Hospital and Monash Children’s Hospital. Peter has a particular interest in the management of juvenile idiopathic arthritis, juvenile dermatomyositis, periodic fever syndromes and paediatric autoimmune diseases such as vasculitis and SLE.
Christina Boros
Christina is a paediatric rheumatologist, who trained at the Hospital for Sick Children in Toronto, Canada and sees patients up to the age of 18 years. Christina consults at the Women's and Children's Hospital, where she is Head of the Rheumatology unit. Her main clinical research interests are in Juvenile arthritis, paediatric SLE and other connective tissue diseases and auto-inflammatory diseases.
Davinder Singh-Grewal
Davinder is a paediatric rheumatologist with over 15 years of experience in the management of children with rheumatic diseases. He completed his rheumatology training at the Hospital for Sick Children in Toronto, Canada and has worked as a Consultant Paediatric Rheumatologist at Great Ormond Street Hospital in London.
Davinder is currently appointed at all three children's hospitals in New South Wales - The Children's Hospital at Westmead, The Sydney Children's Hospital at Randwick and The John Hunter Children's Hospital in Newcastle - along with Liverpool Hospital in South Western Sydney. Davinder is an active member of Arthritis NSW, which is the peak patient group for children with arthritis.
Navid Adib
Navid is a paediatrician specialising in rheumatology and has been practising at The Wesley Hospital since 2006. Navid's areas of interest include paediatric rheumatology, musculoskeletal and inflammatory disorders, juvenile arthritis, juvenile dermatomyositis, lupus and morphea. Navid is passionate about providing health care to children in regional and outback Australia and frequently travels to provide clinics near their homes.
Navid completed his PhD in Paediatric Rheumatology in Manchester, UK. He trained in paediatric rheumatology at Great Ormond Street Hospital, London and The Royal Manchester Children’s Hospital, Manchester. Prior to his current practice, he consulted in paediatric rheumatology in Manchester. He is a member of the Australian Rheumatology Association and a Fellow of the Royal Australian College of Physicians.
Pavla Walsh
Pavla is a Paediatric Rheumatologist and Pain Medicine Specialist, with training and experience in the management of disorders of the musculoskeletal system in childhood. She also works with the Complex Pain and Paediatric Rheumatology teams at Perth Children's Hospital, and the WA Specialist Pain Service in Cottesloe.
Pavla completed her training at Perth Children's Hospital and The Royal Children’s Hospital. She has considerable experience in helping children and young people with chronic pain issues.
Ben Whitehead
Ben is a paediatric rheumatologist and director of paediatric rheumatology at Lady Cilento Children’s Hospital in Brisbane. He has completed training in both general paediatrics and paediatric rheumatology.
Ben and his team provide care and treatment for children and young people with rheumatic diseases, including juvenile idiopathic arthritis as well as young adult rheumatology transition services.
It is a free public health service delivering care to children who live in Queensland and northern New South Wales with outreach to regional centres.
Our research
Why do we study genetics?
Genetics is the study of inherited traits—like eye colour—and how they pass from parents to children. In the future, doctors may use genetic information to diagnose, treat, prevent, and even cure diseases.
Our genes contain instructions for building and regulating proteins. When these instructions have small changes or faults, the body may not function correctly. By understanding these genetic changes, we aim to learn why things go wrong and how to fix them. This research could lead to better medicines, treatments, and possibly cures for conditions like JIA.
What is a biobank?
A biobank is a secure collection of personal health information, tissue samples, and other biospecimens for research. Samples are carefully collected and stored in freezers as cold as -150°C, preserving them for long-term use.
Biobanks allow researchers to gather large, consistent datasets over time, making it easier to identify patterns and links to disease that smaller studies often miss.
Can genetics be used to diagnose JIA?
We’re investigating whether genetic data across the entire human genome can help create a diagnostic test for JIA. This test could be used when children first present with joint or muscle symptoms.
Researchers from Australia, the UK, and the US are collaborating to develop a genetic risk score, which predicts the likelihood of developing JIA. We’ll then test this score in paediatric rheumatology clinics across Australia. This exciting project is funded by the National Health and Medical Research Council (NHMRC).
Why do boys get JIA less often than girls?
Girls are more likely to develop JIA than boys. We have looked at over 60 genetic changes known to be associated with developing JIA overall. We have shown for the first time that several of these genetic changes increase the risk of developing JIA differently depending on whether you are a boy or girl. This work suggests that the genetic causes of JIA differ between the sexes. To take this further, we are now investigating whether genetic changes on the Y chromosome - which only males have - play a role in JIA risk.
Are Vitamin D and Sunshine related to JIA?
Sunlight is a key source of vitamin D, which supports immune health. We’re studying whether sun exposure throughout a child’s life (including in the womb) influences JIA risk.
Are DNA methylation patterns different in children with JIA?
DNA methylation is an epigenetic modification that regulates gene activity and can change over time in response to environmental factors. We’re investigating whether children with JIA have distinct methylation patterns, which could reveal how genes and environment interact in JIA.
Which genes are acting differently in children with JIA?
Genes produce messenger RNA (mRNA), which is then translated into proteins. By comparing mRNA levels in children with and without JIA, we can identify genes that behave differently. This knowledge could lead to new treatments targeting the root causes of JIA.
Publications
Chavez-Valencia R, Chiaroni-Clarke R, Martino D, Munro J, Allen R, Akikusa J, Ponsonby A-L, Craig J, Saffery R, Ellis JA. The DNA methylation landscape of CD4+ T cells in oligoarticular juvenile idiopathic arthritis. Journal of Autoimmunity 2018, 86: 29-38
Beukelman T, Anink J, Berntson L, Duffy C, Ellis JA, Glerup M, Guzman J, Horneff G, Kearsley-Fleet L, Klein A, Klotsche J, Magnusson B, Minden K, Munro JE, Niewerth M, Nordal E, Ruperto N, Santos M, Schanberg LE, Thomson W, van Suijlekom-Smit L, Wulffraat N, Hyrich K. A Survey of National and Multi-National Registries and Cohort Studies in Juvenile Idiopathic Arthritis. Pediatric Rheumatology 2017, 15(1):31
Sun C, Pezic A, Mackey DA, Carlin JB, Kemp A, Ellis JA, Cameron FJ, Rodda CP, Dwyer T, Coroneo MT, Ponsonby AL. Conjunctival ultraviolet autofluorescence as a measure of past sun exposure in children. Cancer Epidemiology, Biomarkers & Prevention 2017, April 26 (Epub ahead of print)
Bima A, Pezic A, Sun C, Cameron FJ, Rodda C, van der Mei I, Chiaroni-Clarke R, Dwyer T, Kemp A, Qu J, Carlin J, Ellis JA, Ponsonby A-L. Environmental and genetic determinants of two vitamin D metabolites in healthy Australian children. Journal of Pediatric Endocrinology and Metabolism 2017, 30(5):531-541
Smith CA, Sun C, Pezic A, Rodda C, Cameron F, Allen K, Craig ME, Carlin J, Dwyer T, Lucas RM, Eyles DW, Kemp AS, Ellis JA, Ponsonby A-L. Determinants of neonatal vitamin D levels as measured on neonatal dried blood spots. Neonatology 2016, 111(2):153-161
Contact us
Please contact us if you wish to:
- Provide feedback on the ANZ CLARITY study
- Update your contact details
- Self-refer to the study
- Find out more about the study
- Withdraw from the study.
The Clarity Study
Murdoch Children's Research Institute
The Royal Children's Hospital
50 Flemington Road
Parkville VIC 3052
Australia
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