[Interferon scores in the management of rheumatic systemic diseases]

Type I interferons (IFN-I) are key mediators of antiviral immune defence and play an important role in the pathogenesis of many rheumatic systemic diseases. Their activity can be indirectly assessed by analyzing interferon-stimulated genes (ISGs) and summarized in a type 1 interferon score (IFN score).

The aim of this review article is to outline the biological background, methodological approaches, clinical applications and limitations of IFN scores in the management of rheumatic systemic diseases.

A narrative literature review was performed focusing on recent original studies and consensus papers addressing the role of IFN scores in connective tissue diseases, idiopathic inflammatory myopathies, rheumatoid arthritis, macrophage activation syndrome and monogenic interferonopathies.

Numerous studies demonstrate increased IFN‑I signatures across different rheumatic diseases. The IFN score can be applied as a diagnostic, predictive and monitoring biomarker. In systemic lupus erythematosus and dermatomyositis, high IFN‑I activity is associated with more severe disease courses but also with better response to IFN-I-targeted treatment. In monogenic interferonopathies, IFN scores also provide an important diagnostic marker.

The IFN score represents a promising biomarker complementing conventional inflammatory parameters and supporting personalized treatment approaches. The broader clinical use is currently limited by methodological heterogeneity, lack of standardization and absence of validated cut-off values. Standardized protocols and prospective studies will be essential for routine clinical implementation.