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<p>Clinical differentiation between systemic autoimmune diseases often relies on late-stage physical symptoms. This study evaluates whether serum cytokine “fingerprints” can provide earlier and more precise diagnostic clarity, particularly for clinically uncategorized patients. Serum samples from 60 patients were analyzed using a 13-plex cytokine array (Aimplex, USA). Subjects were categorized into five groups: Rheumatoid Arthritis (RA, <i>n</i> = 18), Multiple Sclerosis (MS, <i>n</i> = 12), Psoriatic Arthritis (PsA, <i>n</i> = 12), Allergy (<i>n</i> = 6), and Uncategorized (<i>n</i> = 12). Pro-inflammatory (Th1/Th17), regulatory (Th2), and innate cytokines were quantified in pg/mL. Distinct molecular signatures were identified for each cohort with statistically significant variations across groups (<i>p</i> &lt; 0.05). MS patients exhibited significant Th17 polarization (elevated IL-17&#xa0;A), while RA was characterized by the activation of the IL-6/TNF-α axis. Notably, the Uncategorized group demonstrated a median IL-6 of 8.5 pg/mL with a striking interquartile range (IQR) of 2.0–439.0 pg/mL, highlighting the presence of high-intensity inflammatory “explosions” in treatment-naïve patients. In contrast, the Allergy group was distinguished by significantly elevated regulatory IL-10 (median: 6.83 pg/mL) and minimal pro-inflammatory signaling. Discriminant analysis successfully clustered 85% of uncategorized cases into defined immunological profiles based on these profiles. Multi-plex cytokine profiling successfully differentiates between clinically similar pathologies. The extreme cytokine range in uncategorized patients suggests that molecular screening can identify high-risk individuals before formal clinical criteria are met. These findings support the integration of cytokine “fingerprinting” into personalized diagnostic and therapeutic protocols.</p>

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Distinct immunological signatures in autoimmunity: a multi-plex analysis for the differential diagnosis of established and undifferentiated autoimmune diseases (a cross-sectional pilot study)

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Ioannis K. Toliopoulos,
  • Dimitrios Bougiouklis,
  • Panagiotis Papagiannakis,
  • Charalabos Stavridis

摘要

Clinical differentiation between systemic autoimmune diseases often relies on late-stage physical symptoms. This study evaluates whether serum cytokine “fingerprints” can provide earlier and more precise diagnostic clarity, particularly for clinically uncategorized patients. Serum samples from 60 patients were analyzed using a 13-plex cytokine array (Aimplex, USA). Subjects were categorized into five groups: Rheumatoid Arthritis (RA, n = 18), Multiple Sclerosis (MS, n = 12), Psoriatic Arthritis (PsA, n = 12), Allergy (n = 6), and Uncategorized (n = 12). Pro-inflammatory (Th1/Th17), regulatory (Th2), and innate cytokines were quantified in pg/mL. Distinct molecular signatures were identified for each cohort with statistically significant variations across groups (p < 0.05). MS patients exhibited significant Th17 polarization (elevated IL-17 A), while RA was characterized by the activation of the IL-6/TNF-α axis. Notably, the Uncategorized group demonstrated a median IL-6 of 8.5 pg/mL with a striking interquartile range (IQR) of 2.0–439.0 pg/mL, highlighting the presence of high-intensity inflammatory “explosions” in treatment-naïve patients. In contrast, the Allergy group was distinguished by significantly elevated regulatory IL-10 (median: 6.83 pg/mL) and minimal pro-inflammatory signaling. Discriminant analysis successfully clustered 85% of uncategorized cases into defined immunological profiles based on these profiles. Multi-plex cytokine profiling successfully differentiates between clinically similar pathologies. The extreme cytokine range in uncategorized patients suggests that molecular screening can identify high-risk individuals before formal clinical criteria are met. These findings support the integration of cytokine “fingerprinting” into personalized diagnostic and therapeutic protocols.