{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:42:20Z","timestamp":1776339740830,"version":"3.51.2"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,6,26]],"date-time":"2015-06-26T00:00:00Z","timestamp":1435276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Australian National Health and Medical Research Council (NHMRC)"},{"DOI":"10.13039\/501100000923","name":"Australian Research Council (ARC)","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000940","name":"Arthritis Australia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000940","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Rebecca L. Cooper Foundation"},{"name":"LEW Carty Charitable Fund"},{"name":"ANZ Medical Research and Technologies in Victoria Fund"},{"name":"Lynne Quayle Charitable Trust"},{"name":"The Victorian State Government Operational Infrastructure Support Program"},{"name":"Murdoch Childrens Research Institute"},{"name":"NHMRC Senior Research Fellowship"},{"name":"ARC Future Fellowship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Susceptibility to juvenile idiopathic arthritis (JIA) is presumed to be determined by both genes and environment. However, the environmental factors remain largely unknown. The hygiene hypothesis suggests that exposure to siblings, as a marker of exposure to microbes in early life, may protect against the development of later immune disorders. Some prior evidence suggests this may also be true for JIA. The present study was undertaken to test this hypothesis in detail.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a comprehensive analysis of the role of sibling exposure in JIA risk within the Childhood Arthritis Risk Factor Identification Study JIA case\u2013hospital control sample (302 cases and 676 controls) from Victoria, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that, compared to being an only child, having any siblings was protective against JIA, with an adjusted odds ratio (OR) of 0.46 (95% confidence interval [95% CI] 0.28\u20130.74) (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). The protective association appeared to increase with increasing number of siblings (e.g., for \u22653 siblings, adjusted OR 0.25 [95% CI 0.13\u20130.48], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). A protective association of siblings was also observed when we considered cumulative sibling years by age 6 (e.g., for \u22653 years of exposure versus no exposure, adjusted OR 0.49 [95% CI 0.30\u20130.79], <jats:italic>P<\/jats:italic>\u2009=\u20090.003). We also compared cases to a second control sample (n\u2009=\u2009341) collected from the community and weighted to represent the child population of Victoria. Data remained supportive of an association between sibling exposure and protection against JIA, particularly for exposure to younger siblings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increased exposure to siblings is associated with a reduced risk of disease in our sample. This suggests that increased microbial exposure in childhood may confer protection against the development of JIA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.39129","type":"journal-article","created":{"date-parts":[[2015,3,25]],"date-time":"2015-03-25T11:20:00Z","timestamp":1427282400000},"page":"1951-1958","source":"Crossref","is-referenced-by-count":17,"title":["Sibling Exposure and Risk of Juvenile Idiopathic Arthritis"],"prefix":"10.1002","volume":"67","author":[{"given":"Jessica","family":"Miller","sequence":"first","affiliation":[{"name":"Murdoch Childrens Research Institute Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne\u2010Louise","family":"Ponsonby","sequence":"additional","affiliation":[{"name":"Murdoch Childrens Research Institute, Parkville, Victoria, Australia, and University of Melbourne Melbourne Victoria 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