ArticleFrontiers in immunology2026
Immunological coagulation dual axis stratification identifies ultra high-risk phenotypes in systemic sclerosis.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Systemic sclerosis is a heterogeneous autoimmune disease characterized by complex interplay among immune activation, inflammation, coagulation, and fibrinolysis. This study aimed to construct a comprehensive immune-inflammation-coagulation-fibrinolysis (IICF) network and to evaluate its topological features and prognostic value across distinct organ involvement phenotypes. Methods: A total of 287 patients with systemic sclerosis were retrospectively enrolled, including 166 with isolated SSc, 85 with concomitant interstitial lung disease (ILD), 18 with pulmonary hypertension (PH), and 18 with both ILD and PH. Twelve composite indices encompassing IICF pathways were calculated. LASSO-Cox regression was employed to build a multi-index prognostic score, K-means clustering was performed to identify molecular endotypes, and patients were stratified using optimal cut-off values of the Systemic Immune-Inflammation Index (SII) and the D-dimer-to-Platelet Ratio (DPR) for dual-axis survival analysis. Results: Immune-coagulation dual-axis stratification revealed that patients with concurrent elevation of both SII and DPR had a 7.41-fold higher mortality risk than those with dual-low levels (HR 7.41, 95% CI 2.09-26.30, P = 0.002), whereas elevation of either index alone did not reach statistical significance. K-means clustering identified three IICF molecular endotypes, which showed incomplete concordance with the presence of ILD or PH. The multi-index prognostic score yielded an area under the curve of 0.747 for mortality prediction, surpassing the Prognostic Nutritional Index (0.693) and the Neutrophil-to-Lymphocyte Ratio (0.675). Conclusion: Adverse outcomes in systemic sclerosis are driven by systemic network disequilibrium rather than isolated pathway aberrations, with synergistic interplay between immune activation and coagulation dysregulation representing a pivotal mechanism. IICF-based dual-axis stratification and multi-index scoring provide a quantifiable approach for precision phenotyping and may inform stratified therapeutic decision-making.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.