{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T21:11:55Z","timestamp":1780607515009,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The study aims to assess baseline immune parameters that predict infection risk in autoimmune rheumatic disease (ARD) patients, with the goal of identifying high\u2010risk individuals requiring immunosuppressive therapy escalation, based on infection rates during a one\u2010year follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The independent cohort study was conducted at a tertiary rheumatology center in India from December 2019 to March 2022. It included adult participants with ARDs undergoing immunosuppression. Ethics approval and informed consent were obtained. Patients underwent detailed history, clinical examination, and baseline investigations, which included complete hemogram, inflammatory parameters, immunoglobulin levels, cellular levels of the immune system, complement levels, and viral markers. Descriptive statistics, ANOVA, chi\u2010squared tests, <jats:italic>t<\/jats:italic>\u2010tests, and Fisher's exact tests were used. OLS regression analyses identified significant predictors of infection risk. They were followed up for a period of 1\u2009year for any infection episodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 106 participants recruited, 4 were excluded due to disease\u2010related complications during the 3\u2010month period of follow\u2010up. The mean age of the participants was 38.21\u2009\u00b1\u200912.73\u2009years, with an average follow\u2010up duration of 13.1\u2009\u00b1\u20098.35\u2009months. Among the remaining 102 participants, younger age was associated with a lower infection risk (OR 1.047). Protective factors against infection included lower levels of immunoglobulin E (IgE) (OR 0.379), methotrexate (MTX) use (OR 0.247), and biologics (OR 0.543). Conversely, lower Immunoglobulin G (IgG), elevated neutrophil counts (OR 3.588), higher neutrophil\u2010to\u2010lymphocyte ratios (NLR) (OR 2.577), low platelet counts (OR 0.546), and steroid use, which increased the risk fivefold (OR 5.686), were identified as risk factors. Ordinary Least Squares (OLS) regression analysis highlighted age, IgG levels, CD19 lymphocyte counts, WBC counts, and ESR as significant predictors of infection risk between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Older age, low IgG, low B cell count (CD19) predict susceptibility to infections; high neutrophil counts, low platelets, and elevated NLR are key predictors of developing infection in ARDs patients. Careful monitoring and tailored treatment strategies are essential to reduce infection risks. Further research is needed in this direction to develop predictive algorithms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.70187","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T13:01:36Z","timestamp":1742821296000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Old Age, B Cell Function and Count Are the Critical Factors for Predicting Infection Risk in Patients With Autoimmune Rheumatic Diseases Undergoing Immunosuppression: A Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0120-3284","authenticated-orcid":false,"given":"Jaladhar","family":"Prakruthi","sequence":"first","affiliation":[{"name":"ChanRe Rheumatology &amp; Immunology Center &amp; Research  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devaraj","family":"Kori","sequence":"additional","affiliation":[{"name":"ChanRe Rheumatology &amp; Immunology Center &amp; Research  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti","family":"Paramshetti","sequence":"additional","affiliation":[{"name":"ChanRe Rheumatology &amp; Immunology Center &amp; Research  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayid Fahad Nizar","family":"Ahamed","sequence":"additional","affiliation":[{"name":"ChanRe Rheumatology &amp; Immunology Center &amp; Research  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renuka","family":"Panchagnula","sequence":"additional","affiliation":[{"name":"ChanRe Diagnostic Laboratory  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2661-9840","authenticated-orcid":false,"given":"S.","family":"Chandrashekara","sequence":"additional","affiliation":[{"name":"ChanRe Rheumatology &amp; Immunology Center &amp; Research  Bengaluru Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.5152\/eurjrheum.2020.20039"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00265"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.744396"},{"key":"e_1_2_12_5_1","unstructured":"Statista \u201cAutoimmune Spending Worldwide 2011\u20132023 \u201d2024 https:\/\/www.statista.com\/statistics\/1233691\/autoimmune\u2010treatment\u2010spend\u2010worldwide\/."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2014.251"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001379"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.2174\/157488608784529260"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.10.1.86"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2006.06.001"},{"issue":"6","key":"e_1_2_12_11_1","first-page":"401","article-title":"Infections in Liver Transplant Recipients","volume":"25","author":"Aguado J. 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