Serum YKL-40 level is associated with severity of interstitial lung disease and poor prognosis in dermatomyositis with anti-MDA5 antibody
Serum YKL-40 level is associated with severity of interstitial lung disease and poor prognosis in dermatomyositis with anti-MDA5 antibody
复制标题
血清YKL-40水平与间质性肺疾病的严重程度以及抗MDA5抗体皮肌炎的不良预后相关。
DOI：
10.1007/s10067-019-04457-w
复制
发表时间：
2019-06-01
影响因子：
3.4
通讯作者：
Wu, Xiaomu
中科院分区：
文献类型：
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作者：
Jiang, Lili;Wang, Youlian;Wu, Xiaomu
目的探讨抗MDA 5抗体阳性皮肌炎（anti-MDA 5（+）DM）患者血清几丁质酶-3-样蛋白-1（YKL-40）检测的临床价值。采用酶联免疫吸附法（ELISA）检测患者基线及随访时血清YKL-40水平。我们评估了YKL-40与快速进展性间质性肺病（RPILD）、间质性肺病（ILD）严重程度和ILD相关生存率的关系。与无RPILD的患者相比，抗-MDA 5（+）DM患者的血清YKL-40水平显著升高（p=0.011）。治疗一个月后，ILD恶化的患者YKL-40水平升高，而ILD稳定/改善的患者YKL-40水平降低。血清铁蛋白和YKL-40水平升高以及外周血CD 3（+）T细胞计数降低与预后不良独立相关。Kaplan-Meier生存曲线显示，血清YKL-40水平高（> 80 ng/ml）的患者6个月生存率显著低于血清YKL-40水平低（> 80 ng/ml）的患者。
Objective We aimed to investigate the clinical value of checking serum chitinase-3-like-1 protein (YKL-40) levels in anti-MDA5 antibody-positive dermatomyositis (anti-MDA5(+)DM) patients.Methods One hundred and five consecutive anti-MDA5(+)DM patients and 44 healthy controls were enrolled in this study. Baseline and follow-up serum YKL-40 were detected by ELISA. We evaluated the association of YKL-40 with rapidly progressive interstitial lung disease (RPILD), severity of interstitial lung disease (ILD), and ILD-related survival.Results Forty-one out of 105 anti-MDA5(+)DM patients had RPILD at the time of serum sample collection (39.0%). Serum YKL-40 levels were significantly higher in anti-MDA5(+)DM patients with RPILD compared with those without (p=0.011). One month after treatment, patients with aggravated ILD had increased YKL-40 levels, while those with stable/improved ILD had decreased YKL-40 levels. Higher serum levels of ferritin and YKL-40, as well as lower peripheral CD3(+)T cell counts, were independently associated with poorer prognosis. Kaplan-Meier survival curve showed that the 6months survival rate in patients with high serum YKL-40 level (>80ng/ml) was significantly lower than that in patients with low YKL-40 level (