Anti-MDA5 antibody is associated with A/SIP and decreased T cells in peripheral blood and predicts poor prognosis of ILD in Chinese patients with dermatomyositis
Anti-MDA5 antibody is associated with A/SIP and decreased T cells in peripheral blood and predicts poor prognosis of ILD in Chinese patients with dermatomyositis
复制标题
抗 MDA5 抗体与 A/SIP 和外周血 T 细胞减少相关，可预测中国皮肌炎患者 ILD 的不良预后
DOI：
10.1007/s00296-011-2323-y
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发表时间：
2012-12-01
影响因子：
4
通讯作者：
Wang, Guochun
中科院分区：
文献类型：
--
作者：
Chen, Fang;Wang, Dongxue;Wang, Guochun
本研究的目的是检测多发性肌炎和皮肌炎(PM/DM)患者血清中抗黑色素瘤分化相关基因5的患病率及其临床相关性。用双抗体夹心法检测113例成人PM/DM患者和正常对照血清中抗MDA5抗体。采用流式细胞术分析PM/DM患者外周血中淋巴细胞亚群。DM组血清抗MDA5阳性率(22.6%)显著高于PM组(0%，P<0.005)、SLE组(3.3%，P<0.05)、RA组(3.3%，P<0.05)、PSS组(0%，P<0.05)、肺部感染组(0%，P<0.05)和健康对照组(0%，P<0.001)。抗MDA5阳性DM组外周血中CD4+、CD8+T细胞下降百分率、CD4+/CD8+比值升高及急性/亚急性间质性肺炎(A/SIP)发生率均显著高于MDA5阴性组(P均<0.05)。Logistic多因素分析显示，抗MDA5抗体是糖尿病合并ILD死亡的独立危险因素(OR=78.46，95%CI1.77~40.36，P=0.007)。综上所述，在中国PM/DM患者中，抗MDA5抗体主要存在于DM患者中，可作为DM患者A/SIP的有用标志物。它可以预测糖尿病合并ILD患者的不良预后。外周血中异常T细胞如何参与抗MDA5抗体的产生尚需进一步研究。
The aim of this study is to determine serum anti-melanoma differentiation-associated gene 5 prevalence and their clinical associations in Chinese patients with polymyositis and dermatomyositis (PM/DM). Serum anti-MDA5 antibody was detected by ELISA in 113 adult PM/DM patients and in various controls. Flow cytometry was applied to analyze the subgroups of lymphocytes in the peripheral blood of PM/DM patients. The serum anti-MDA5-positive rate in the DM patients (22.6%) was significantly higher compared with that in PM patients (0%,P< 0.005), patients with SLE (3.3%,P< 0.05), RA (3.3%,P< 0.05), pSS (0%,P< 0.05), pulmonary infection (0%,P< 0.05) and healthy controls (0%,P< 0.001). The percentage of decreased CD4+, CD8+T cell counts, raised CD4+/CD8+ratio in peripheral blood and the incidence of acute/subacute interstitial pneumonia (A/SIP) were significantly higher in anti-MDA5-positive DM group than negative group (allP< 0.05). Additionally, logistic multivariate analysis showed that anti-MDA5 is an independent risk factor for death of ILD in DM (OR = 8.46, 95% CI 1.77–40.36,P= 0.007). In conclusion, in Chinese PM/DM patients, serum anti-MDA5 antibody is mainly presented in DM patients and can be a useful marker for A/SIP in patients with DM. It can predict unfavorable prognosis in DM patients with ILD. Further studies are needed to identify how the abnormal T cells in peripheral blood participated in the generation of the anti-MDA5 antibody.