#5-94E. Unveiling the Immunologic Bridge: Interleukin-18 and CD8+ T Cell Expansion in Still Disease and MAS (Arthritis Rheumatol, 2026)

How does systemic inflammation in Still disease evolve into the life-threatening cytokine storm of macrophage activation syndrome? Rogani and colleagues demonstrate that pathogenic CD38+HLA-DR+CD8+ T cells expand early at Still disease onset and peak during macrophage activation syndrome, driven by persistent interleukin-18 exposure. Although limited by a relatively small single-center cohort requiring larger prospective validation, this study reveals an immunologic continuum between these conditions. Monitoring this distinct T-cell subset alongside interleukin-18 may help clinicians stratify high-risk patients early and implement targeted anti-interleukin-18 interventions before severe complications unfold.

Citation: Rogani G, Erkens RGA, Bodelón A, et al. Persistent Interleukin-18 Fuels Expansion of CD38+HLA-DR+CD8+ T Cells in Still Disease and Macrophage Activation Syndrome. Arthritis & Rheumatology. 2026.

URL: https://doi.org/10.1002/art.70319

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