Distinct cytokine and chemokine alterations in bronchoalveolar fluid from patients with systemic juvenile idiopathic arthritis associated lung disease (SJIA-LD)
Authors' conclusion
Patients with SJIA-LD showed a distinct BALF cytokine profile, including significant IL-18, S100A8/9 protein, sCD25, and CCL-17 elevation. The level of IL-18 was higher in patients who required more immunosuppressive medications and were actively treated with anti-cytokine biologics.
Study context
- Population
- Children with sJIA-associated lung disease undergoing clinically indicated diagnostic bronchoscopy; comparators with other lung diseases
- Participants
- 21 vs 54
- Exposure
- SJIA-LD vs comparator patients with other chronic inflammatory and non-inflammatory lung diseases
- SJIA-LDn = 21
- Controlsn = 54reference
- Outcome
- Levels of cytokines and chemokines in BALF
Methodological detailscase-control comparison
- Case-control comparison
Main finding
As reported in the abstract
BALF cytokine and chemokine levels
- SJIA-LD vs Controls: P < 0.0001
- SJIA-LD vs Controls: P = 0.02
- SJIA-LD vs Controls: P = 0.04
- SJIA-LD vs Controls: P = 0.0384
- SJIA-LD vs Controls: P = 0.038
- Values are median (IQR)
Observational data: associations, not effects.
Further findings
Bronchoalveolar lavage fluid (BALF) IL-18 by control subgroup and treatment
- IL-18 significantly higher in SJIA-LD vs all control subgroups (inflammatory and non-inflammatory airway disease, autoimmune pulmonary alveolar proteinosis, poorly controlled asthma), in patients on anti-cytokine biologics (N = 9) and in those who underwent hematopoietic stem cell transfer (N = 8)
- Anti-cytokine biologics: significant elevations in several other cytokines vs untreated; JAKi-treated (N = 14) profiles largely similar
Association of BALF IL-18 with number of immunosuppressive medications (linear regression)
- Association with number of immunosuppressive medications
- P = 0.0167
- No association with O2 requirement, anakinra or prednisone dose, plasma IL-18, ferritin, CRP or ESR
Original publication
Distinct cytokine and chemokine alterations in bronchoalveolar fluid from patients with systemic juvenile idiopathic arthritis associated lung disease (SJIA-LD). Arthritis Res Ther. Published 17 July 2026. doi:10.
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