Analysis Of The Associations Between Serum Ferritin and Cytokines In Pulmonary Disease Activity With Polymyositis/Dermatomyositis

Hidenaga Kawasumi, Takahisa Gono, Yasushi Kawaguchi, Yasuhiro Katsumata, Masanori Hanaoka, Sayuri Kataoka, Kae Takagi, Hisae Ichida, Sayumi Baba, Yuko Okamoto, Yuko Ota and Hisashi Yamanaka, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: cytokines, Polymyositis/dermatomyositis (PM/DM) and pulmonary complications

Session Information

Title: Muscle Biology, Myositis and Myopathies: Advances in the Epidemiology, Immunology and Therapy of Myositis

Session Type: Abstract Submissions (ACR)

Background/Purpose: Polymyositis (PM) / dermatomyositis (DM) is occasionally complicated by interstitial lung disease (ILD), and ILD is a prognostic factor in PM/DM. We previously reported that high levels of serum ferritin are associated with the severity and prognosis of ILD in patients with PM/DM. Hyperferritinemia could be associated with a cytokine storm in rapidly progressive ILD associated with PM/DM. The reason for the serum ferritin increase in ILD with PM/DM is unknown. We investigated the associations between the serum ferritin levels and various cytokines in patients with PM/DM.

Methods: This retrospective study included 38 patients admitted to our hospital with PM/DM. Among 38 patients, PM/DM was a complication of ILD in 21 patients. Serum cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, IL-17, TNF-α, INF-α, INF-γ and IP-10) were measured by a multiplex assay. Global disease activity and the disease activity of ILD were evaluated by the Myositis Intention to Treat Activity Index (MITAX) and the pulmonary visual analogue scale (Pulmonary VAS), which the International Myositis Assessment and Clinical Studies Group has proposed and recommended, respectively. We analyzed the associations between the disease activity, serum ferritin and cytokines.

Results: The MITAX was significantly correlated with the following: ferritin (r_s=0.53), IL-6 (r_s=0.61), IL-8 (r_s=0.37), IL-10 (r_s=0.44), TNF-α (r_s=0.58) and IP-10 (r_s=0.47). The Pulmonary VAS was significantly correlated with the following: ferritin (r_s=0.62), IL-8 (r_s=0.45), IL-10 (r_s=0.46), TNF-α (r_s=0.45) and IP-10 (r_s=0.33). The serum ferritin levels were significantly correlated with IL-6 (r_s=0.40), IL-8 (r_s=0.57), IL-10 (r_s=0.50) and TNF-α (r_s=0.34). To clarify the degree to which these cytokines contribute to the ferritin levels, we performed a multiple linear regression analysis. IL-6 (t=3.6, p=0.0010), IL-8 (t=4.8, p<0.0001) and IL-10 (t=5.7, p<0.0001) were significantly associated with the ferritin levels.

Conclusion: Serum ferritin was correlated with the pulmonary disease activity and with global disease activity in PM/DM. IL-6, IL-8 and IL-10 were significant factors that contributed to the serum ferritin levels. The regulation of these cytokines might be a possible treatment strategy for ILD with PM/DM.

Disclosure:

H. Kawasumi,
None;

T. Gono,
None;

Y. Kawaguchi,
None;

Y. Katsumata,
None;

M. Hanaoka,
None;

S. Kataoka,
None;

K. Takagi,
None;

H. Ichida,
None;

S. Baba,
None;

Y. Okamoto,
None;

Y. Ota,
None;

H. Yamanaka,
None.

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