Clinical significance of soluble CD163 in polymyositis-related or dermatomyositis-related interstitial lung disease.
Clinical significance of soluble CD163 in polymyositis-related or dermatomyositis-related interstitial lung disease.
复制标题
可溶性CD163在与多肌炎相关或皮肤炎相关的间质肺疾病中的临床意义。
DOI：
10.1186/s13075-016-1214-8
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发表时间：
2017-01-19
影响因子：
4.9
通讯作者：
Suda T
中科院分区：
文献类型：
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作者：
Enomoto Y;Suzuki Y;Hozumi H;Mori K;Kono M;Karayama M;Furuhashi K;Fujisawa T;Enomoto N;Nakamura Y;Inui N;Suzuki D;Ogawa N;Nakashima R;Mimori T;Iwashita T;Suda T
巨噬细胞活化参与了多发性肌炎(PM)/皮肌炎(DM)的发病。CD163是一种表达于活化巨噬细胞表面的清道夫受体，介导抗炎功能。本研究旨在探讨血清可溶性CD163(SCD163)在PM/DM相关性间质性肺疾病(ILD)中的临床意义。研究对象为48例PM/DM相关性ILD患者。以10例无ILD的PM/DM患者和20例健康志愿者为对照。在PM/DM相关性ILD患者中，通过回顾患者的病历获得基线特征和临床病程。诊断ILD时的血清sCD163水平用酶联免疫吸附试验进行定量，并与其他基线临床指标进行比较，评估其作为预后生物标志物的可能性。另外，用抗人CD163抗体对2例DM相关性ILD患者(分别为1例存活者和1例非存活者)和1例早期肺癌患者的肺切片进行免疫组织化学分析。PM/DM相关ILD患者血清sCD163的中位数为818 ng/mL，高于无ILD的PM/DM患者和健康志愿者的中位数(分别为716 ng/mL和340 ng/mL)。在PM/DM相关的ILD患者中，血清C-反应蛋白水平(r = 0.322)和预计用力肺活量百分比(r = −0.301)与血清sCD163水平有显著但轻微的相关性。COX比例风险模型显示，与PM/DM相关的ILD和sCD163值升高的患者预后较差(年龄调整和性别调整的风险比每100ngmL增加1.27%，95%可信区间1.111.45，P<；0.001)。免疫组织化学分析显示，与正常肺相比，DM相关ILD患者肺组织中CD163阳性巨噬细胞明显增多。尤其是在非幸存者的肺中发现的情况更为严重。血清sCD163可能成为预测PM/DM相关性ILD严重程度和预后的潜在生物标志物。我们的结果提示巨噬细胞激活在疾病中的重要性。本文的在线版本(doi：10.1186/s13075-016-1214-8)包含补充材料，授权用户可以使用。
Macrophage activation is involved in the pathogenesis of polymyositis (PM)/dermatomyositis (DM). CD163, a scavenger receptor expressed on the surface of activated macrophages, mediates anti-inflammatory functions. This study aimed to evaluate the clinical significance of soluble CD163 (sCD163) in PM/DM-related interstitial lung disease (ILD). The main subjects were 48 patients with PM/DM-related ILD. As controls, 10 patients with PM/DM without ILD and 20 healthy volunteers were enrolled. In patients with PM/DM-related ILD, the baseline characteristics and clinical course were obtained through a review of patient medical records. Serum sCD163 levels at ILD diagnosis were quantified by enzyme-linked immunosorbent assay, which were compared with the other baseline clinical factors and evaluated for potential as a prognostic biomarker. In addition, immunohistochemistry analysis using anti-human CD163 antibody was performed on the lung sections of two patients with DM-related ILD (a survivor and non-survivor, respectively) and one patient with early-stage lung cancer as a normal control. The median value of serum sCD163 in patients with PM/DM-related ILD was 818 ng/mL, which was higher than that of PM/DM patients without ILD and healthy volunteers (716 ng/mL and 340 ng/mL, respectively). Significant but mild correlations with serum sCD163 levels were observed for serum C-reactive protein levels (r = 0.322) and % predicted forced vital capacity (r = −0.301) in patients with PM/DM-related ILD. A Cox proportional hazard model demonstrated that patients with PM/DM-related ILD and higher sCD163 levels had worse prognosis (age-adjusted and gender-adjusted hazard ratio per 100 ng/mL increase 1.27, 95% confidence interval 1.11–1.45, P <0.001). In immunohistochemistry analysis, compared with normal lung, alveolar infiltration of CD163-positive macrophages was evident in the lungs of patients with DM-related ILD. Especially, the finding was more severe in the non-survivor’s lung. Serum sCD163 might be a potential biomarker for predicting the severity and prognosis of PM/DM-related ILD. Our results suggest the importance of macrophage activation in the disease. The online version of this article (doi:10.1186/s13075-016-1214-8) contains supplementary material, which is available to authorized users.