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Systemic Inflammatory Response Index, a Potential Inflammatory Biomarker in Disease Severity of Myasthenia Gravis: A
Suwen Huang1, Yanchu Wang1,2, Jinrong Zhu1,3
1Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Purpose:
Myasthenia gravis (MG) is a chronic autoimmune disease caused by neuromuscular junction (NMJ) dysfunction. Our current understanding of MG's inflammatory component remains poor. The systemic inflammatory response index (SIRI) presents a promising yet unexplored biomarker for assessing MG severity. This study aimed to investigate the potential relationship between SIRI and MG disease severity.
Patients And Methods:
We conducted a retrospective analysis of clinical data from 171 MG patients admitted between January 2016 and June 2021. Patients with incomplete data, other autoimmune diseases, or comorbidities were excluded. Disease severity was evaluated using the Myasthenia Gravis Foundation of America (MGFA) classification and Myasthenia Gravis Activities of Daily Living (MG-ADL) on admission. The association between SIRI and disease severity was assessed through logistic regression analysis, along with receiver operating characteristic (ROC) curve and decision curve analysis (DCA) comparisons with established inflammation indicators.
Results:
After exclusion, 143 patients were analyzed in our study. SIRI levels significantly differed between patients with higher and lower disease severity (p < 0.001). Univariate logistic regression showed that SIRI had a significant effect on high disease severity (OR = 1.376, 95% CI 1.138-1.664, p = 0.001). This association remained significant even after adjusting for age, sex, disease duration, history of MG medication and thymoma (OR = 1.308, 95% CI 1.072-1.597, p = 0.008). Additionally, a positive correlation between SIRI and MG-ADL was observed (r = 0.232, p = 0.008). Significant interactions were observed between SIRI and immunosuppressor (p interaction = 0.001) and intravenous immunoglobulin (p interaction = 0.005). DCA demonstrated the superior net clinical benefit of SIRI compared to other markers when the threshold probability was around 0.2.
Conclusion:
Our findings indicate a strong independent association between SIRI and disease severity in MG, suggesting SIRI's potential as a valuable biomarker for MG with superior clinical benefit to currently utilized markers.
Insights
The systemic inflammatory response index (SIRI) is a potential biomarker for assessing myasthenia gravis (MG) severity. This study found SIRI strongly correlates with MG disease severity and offers superior clinical benefit over existing markers.
Area of Science:
- Neurology
- Immunology
- Biomarker Discovery
Background:
- Myasthenia gravis (MG) is a chronic autoimmune neuromuscular junction disorder with poorly understood inflammatory components.
- The systemic inflammatory response index (SIRI) is an emerging biomarker for inflammation, yet its role in MG severity assessment is unexplored.
Purpose of the Study:
- To investigate the association between SIRI and disease severity in patients with myasthenia gravis.
- To evaluate SIRI as a potential biomarker for MG severity compared to established indicators.
Main Methods:
- Retrospective analysis of clinical data from 143 myasthenia gravis patients.
- Disease severity assessed using MGFA classification and MG-ADL.
- Logistic regression, ROC curve, and DCA used to analyze SIRI's association with severity.
Main Results:
- SIRI levels significantly differed between high and low MG disease severity groups (p < 0.001).
- SIRI showed a significant independent association with high MG disease severity (OR = 1.308, p = 0.008) and correlated positively with MG-ADL (r = 0.232, p = 0.008).
- Decision curve analysis indicated SIRI offers superior clinical utility compared to other markers.
Conclusions:
- SIRI is a strong, independent predictor of disease severity in myasthenia gravis.
- SIRI demonstrates potential as a valuable biomarker for MG, offering enhanced clinical benefit over current markers.
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