Back to Search
Start Over
The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM.
- Source :
-
Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2012 Jul; Vol. 51 (7), pp. 1278-84. Date of Electronic Publication: 2012 Feb 29. - Publication Year :
- 2012
-
Abstract
- Objective: Interstitial lung disease (ILD), especially rapidly progressive ILD (RPILD), is a major poor prognostic factor in patients with DM. We investigated the association of anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab) with clinical characteristics and mortality in Japanese patients with DM.<br />Methods: Seventy-nine DM patients, comprising 58 classic DM and 21 clinically amyopathic DM (CADM) patients, were enrolled. Serum Abs were screened by immunoprecipitation assays, and an immunosorbent assay (ELISA) was used for MDA5. The relationships of clinical characteristics and mortality with each Ab were investigated.<br />Results: Anti-MDA5 Ab was detected in 17 patients. Anti-clinically amyopathic DM 140 kDa polypeptide Abs (anti-CADM-140 Abs) were found in 16 of the 17 anti-MDA5 Ab(+) patients. Skin ulcers, palmar papules, CADM, RPILD and mediastinal emphysema were widely distributed in anti-MDA5 Ab(+) patients. Mortality at 6 months as well as 5 years was also significantly higher in anti-MDA5 Ab(+) patients than in anti-MDA5 Ab(-) patients. In a multivariable Cox regression analysis, mortality was independently associated with anti-MDA5 Ab (relative hazard 6.33; 95% CI 1.43, 28.0). All of the deaths in anti-MDA5 Ab(+) patients were attributed to respiratory failure of RPILD; however, RPILD did not worsen in any of the anti-MDA5 Ab(+) patients who survived the first 6 months.<br />Conclusion: The presence of anti-MDA5 Ab identifies the characteristic skin, musculoskeletal, pulmonary and prognostic features in patients with DM. In addition, anti-MDA5 Ab seems to predict a group of patients with CADM-complicated fatal RPILD.
- Subjects :
- Antibodies, Anti-Idiotypic blood
Autoantibodies blood
DEAD-box RNA Helicases blood
Dermatomyositis complications
Dermatomyositis epidemiology
Diagnosis, Differential
Disease Progression
Female
Follow-Up Studies
Humans
Incidence
Interferon-Induced Helicase, IFIH1
Japan epidemiology
Lung Diseases, Interstitial epidemiology
Lung Diseases, Interstitial etiology
Male
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
Survival Rate trends
Antibodies, Anti-Idiotypic immunology
Autoantibodies immunology
DEAD-box RNA Helicases immunology
Dermatomyositis diagnosis
Enzyme-Linked Immunosorbent Assay statistics & numerical data
Immunoprecipitation statistics & numerical data
Lung Diseases, Interstitial diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1462-0332
- Volume :
- 51
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Rheumatology (Oxford, England)
- Publication Type :
- Academic Journal
- Accession number :
- 22378718
- Full Text :
- https://doi.org/10.1093/rheumatology/ker518