Background: Interleukin-18 (IL-18), an IL-1 family cytokine with potent ability to induce interferon gamma production and enhance Th1 response, was elevated in a group of autoimmune diseases including primary Sjögren syndrome (pSS). IL-18 dysregulation can contribute to the pathogenesis of these disorders by exerting function in innate and adaptive immunity. This study is aimed at comparing the level of IL-18 in pSS patients and explored the association between IL-18 and pSS. Methods: Six databases, including PubMed, Web of Science, Embase, Ovid Medline, Scopus and China National Knowledge Infrastructure, were searched. The quality of the included studies was assessed using the Newcastle–Ottawa Scale criteria. We analyzed IL-18 concentrations in the serum and tear of pSS patients and healthy controls (HCs), and review the potential mechanism between IL-18 and pSS. Results: Eleven articles were included in this study, which reported IL-18 levels in serum and tear of pSS patients and HCs. IL-18 levels in pSS patients were significantly higher than those in HCs (standard mean difference = 1.28, 95% confidence interval 0.75–1.82, P < .001), with substantial heterogeneity (I ² = 90%, P < .001) among the studies. The level of IL-18 in serum was analyzed separately and was also higher than those in HCs (standard mean difference = 1.28, 95% confidence interval 0.68–1.88, P < .001), with significant heterogeneity (I ² = 91%, P < .001). Apart from that, the potential pathogenesis of pSS was concluded comprehensively. Conclusion: IL-18 abundance was evidently elevated in pSS patients and can thus likely be used as a reliable biomarker to monitor and track the progression of pSS, and further to become a good target for treatment of pSS patient.

Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease (ESRD). Early diagnosis is therefore critical for improving patient outcomes.However, traditional clinical biomarkers are constrained by diagnostic latency and limited sensitivity, particularly in cases of non-albuminuric DKD. To address these limitations, this review systematically explores the technical framework of the pathology-anchored strategy and proposes a two-phase translational approach, consisting of Pathology Anchoring Discovery and Prospective Early Validation. This strategy employs renal biopsy as the pathological gold standard in conjunction with multi-omics technologies to correlate circulating or urinary molecules with specific renal histological lesions, ultimately identifying non-invasive biomarkers with definitive pathological relevance. While numerous biomarkers demonstrate early warning potential in high-risk populations with normal conventional indicators, the pathology-anchored framework serves as a critical bridge linking these clinical biomarkers and distinct pathological changes. This review presents potential insights for early identification, risk stratification, and prognostic assessment of DKD.