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Examining the Relationship between Systemic Immune-Inflammation Index and Disease Severity in Juvenile Idiopathic
Delia-Maria Nicoară1, Andrei-Ioan Munteanu1,2,3, Alexandra-Cristina Scutca1,2
1Department XI Pediatrics, Discipline I Pediatrics, 'Victor Babeş' University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, Romania.
Insights
The systemic immune inflammation index (SII) effectively reflects disease severity and inflammation in children with Juvenile Idiopathic Arthritis (JIA). This index shows strong correlations with established markers and can help identify high disease activity in JIA patients.
Area of Science:
- Pediatric Rheumatology
- Immunology
- Biomarker Discovery
Background:
- Juvenile Idiopathic Arthritis (JIA) is a chronic childhood rheumatic disease with potential long-term complications.
- Accurate assessment of disease activity is vital for effective management, especially with advanced therapies.
- Inflammation is central to JIA, necessitating reliable measures of inflammatory activity and disease severity.
Purpose of the Study:
- To investigate the potential of the Systemic Immune Inflammation Index (SII) as a measure of inflammation and disease severity in pediatric JIA.
- To explore the correlation of SII with established inflammatory markers and clinical disease activity scores in JIA.
- To evaluate the ability of SII to differentiate between varying levels of disease activity in JIA.
Main Methods:
- Retrospective study involving 74 JIA patients and 50 healthy controls.
- Analysis of Systemic Immune Inflammation Index (SII) values in relation to disease severity.
- Correlation analysis with C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), and Juvenile Arthritis Disease Activity Score 10 (JADAS10).
- Multiple regression analysis to determine independent associations.
- Receiver operating characteristic (ROC) curve analysis to assess diagnostic performance.
Main Results:
- Median SII values were significantly increased and correlated with disease severity in JIA patients.
- SII demonstrated strong positive correlations with CRP (ρ=0.714), ESR (ρ=0.661), and JADAS10 (ρ=0.690).
- The SII was independently associated with JADAS10 via multiple regression analysis.
- SII accurately distinguished high disease activity from other severity groups (AUC=0.827, sensitivity=81.5%, specificity=66%).
Conclusions:
- The Systemic Immune Inflammation Index (SII) shows significant potential as a valuable tool for assessing inflammation and disease severity in Juvenile Idiopathic Arthritis.
- SII correlates well with established inflammatory markers and clinical disease activity scores, offering a comprehensive view of disease status.
- Integrating SII into clinical practice may enhance the precise assessment of disease activity and guide treatment decisions in pediatric JIA management.
Abstract:
Juvenile Idiopathic Arthritis (JIA), the leading childhood rheumatic condition, has a chronic course in which persistent disease activity leads to long-term consequences. In the era of biologic therapy and tailored treatment, precise disease activity assessment and aggressive intervention for high disease activity are crucial for improved outcomes. As inflammation is a fundamental aspect of JIA, evaluating it reflects disease severity. Recently, there has been growing interest in investigating cellular immune inflammation indices such as the neutrophil-to-lymphocyte ratio (NLR) and systemic immune inflammation index (SII) as measures of disease severity. The aim of this retrospective study was to explore the potential of the SII in reflecting both inflammation and disease severity in children with JIA. The study comprised 74 JIA patients and 50 healthy controls. The results reveal a notable increase in median SII values corresponding to disease severity, exhibiting strong correlations with traditional inflammatory markers, including CRP and ESR (ρ = 0.714, ρ = 0.661), as well as the JADAS10 score (ρ = 0.690). Multiple regression analysis revealed the SII to be independently associated with JADAS10. Furthermore, the SII accurately distinguished patients with high disease activity from other severity groups (AUC = 0.827, sensitivity 81.5%, specificity 66%). These findings suggest that integrating the SII as an additional measure holds potential for assessing disease activity in JIA.
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