Distinct cytokine and chemokine alterations in bronchoalveolar fluid from patients with systemic juvenile…

Cohort studyArthritis research & therapy· Jul 2026

Distinct cytokine and chemokine alterations in bronchoalveolar fluid from patients with systemic juvenile idiopathic arthritis associated lung disease (SJIA-LD).

Ivanna Romankevych, Alyssa Sproles, Thuy Do … Grant Schulert

Pediatric RheumatologyCohort studyQ1IF 5.1

Bronchoalveolar lavage fluid IL-18 markedly elevated in systemic JIA-associated lung disease vs other lung diseases

Distinct cytokine and chemokine alterations in bronchoalveolar fluid from patients with systemic juvenile idiopathic arthritis associated lung disease (SJIA-LD).

Ivanna Romankevych … Grant Schulert

Arthritis research & therapy · Jul 2026

Background

Lung disease associated with systemic juvenile idiopathic arthritis (SJIA-LD) remains poorly understood.

Purpose

The objectives of our study were to measure levels of cytokines and chemokines in bronchoalveolar lavage fluid and their associations with clinical features and treatment in patients with SJIA-LD.

Methods

Children with SJIA-LD undergoing clinically indicated diagnostic bronchoscopy were enrolled.

n = 21 patients

Results

IL-18 far higher in SJIA-lung disease than in other lung diseases

SJIA-LD

1406pg/mL

Control

37.2pg/mL

More results

13.645 (8.6-37.3) pg/mL, p = 0.0384), and CCL17 (0 (0-63.1; p = 0.038) vs 0 (0-0) pg/mL.

More results

Bronchoalveolar lavage fluid IL-18 was significantly higher in children with SJIA-LD compared to all control subgroups (inflammatory and non-inflammatory airway disease, autoimmune pulmonary alveolar proteinosis, and poorly controlled asthma), in patients who were actively treated with anti-cytokine biologics (N = 9), and in patients who ultimately underwent hematopoietic stem cell transfer (N = 8).

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Conclusion · 1 of 3

Patients with SJIA-LD showed a distinct bronchoalveolar lavage fluid cytokine profile, including significant IL-18, S100A8/9 protein, sCD25, and CCL-17 elevation.

Conclusion · 2 of 3

The level of IL-18 was higher in patients who required more immunosuppressive medications and were actively treated with anti-cytokine biologics.

Conclusion · 3 of 3

The relationship between bronchoalveolar lavage fluid cytokine profiles and anti-cytokine biologics and JAK inhibitors is unclear and should be evaluated further.

Distinct cytokine and chemokine alterations in bronchoalveolar fluid from patients with systemic juvenile idiopathic arthritis associated lung disease (SJIA-LD).

Distinct cytokine and chemokine alterations in bronchoalveolar fluid from patients with systemic juvenile idiopathic arthritis associated lung disease (SJIA-LD).

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