Background/Purpose: To investigate and compare the association between serum markers and Interstitial Lung Disease (ILD) in patients with inflammatory myopathies(IIM).

Methods: Serum levels of KL-6, anti- melanoma differentiation-associated gene 5(MDA5), monocyte chemotactic protein-1 (MCP-1),Surfactant protein-A,D(SP-A ,SP-D) were detected by ELISA in 119 adult IIM patients and 50 healthy controls. The association between serum levels and clinical signs of ILD in patients with IIM was analyzed.

Results: serum KL-6, anti-MDA5,MCP-1,SP-A,SP-D were significantly  elevated in IIM patients with ILD( all P<0.05). KL-6 showed the highest value (sensitivity 90.9% and specificity 80.6%) for diagnosing ILD.  Anti-MDA5 could effectively diagnose acute/subacute interstitial pneumonia (A/SIP) in DM patients (sensitivity 88.2%, specificity 94%). Patients with elevated KL-6 showed more frequently ground glass opacity than those with normal KL-6(all P<0.05). Inverse correlations were found between serum KL-6/SP-A/SP-D and lung function parameters such as DLCO% and FVC(all P<0.05). KL-6(OR 1.032, 95%CI1.006-1.059,P=0.016) and anti-MDA5 (OR = 8.46, 95% CI 1.77–40.36, P = 0.007) are independent risk factors predicting unfavorable prognosis in IIM patients with ILD.

Conclusion: Serum KL-6, anti-MDA5,MCP-1,SP-A,SP-D are useful markers for ILD in IIM patients, of which KL-6 presented highest diagnosing value. Anti-MDA5  may be a useful marker for A/SIP in patients with DM. these biomarkers can help diagnosing ILD and predicting prognosis in IIM patients with ILD though they cannot replace conventional diagnosing procedure.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-comprehensive-study-of-novel-serum-markers-of-ild-associated-with-inflammatory-myopathies/