Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Polymyositis (PM)/dermatomyositis (DM) is a chronic inflammatory disorders involved in skeletal muscles. Interstitial lung disease (ILD) complicated with PM/DM patients is often developed as rapidly progressive ILD (RPILD), which can be treatment resistant and life threatening. However, serum biomarkers of PM/DM with RPILD still remain to be obscure. This study was aimed to identify the specific biomarkers to assess PM/DM complicated with RPILD.
Methods: Forty-six patients with PM/DM-ILD, in either RPILD (n = 20) or chronic ILD (n = 26), were enrolled from Nagasaki University Hospital and related institutions. They gave their informed consent to be subjected to the protocol that was approved by the Institutional Review Board of Nagasaki University. Using medical records, we analyzed the patientfs demographics and clinical characteristics. Serum levels of 42 cytokines/chemokines were measured by multi-suspension cytokine array. Serum levels of anti-melanoma differentiation-associated gene 5 (MDA5) antibody, ferritin and interferon-alpha (IFN- alpha) were measured by enzyme linked immunosorbent assay. These serum variables were ranked by their importance by a multivariate classification algorithm termed random forest analysis. We performed a logistic regression analysis to determine a set of specific biomarkers for distinguishing patients with RPILD from patients with chronic ILD.
Results: Patients with RPILD had significantly higher age, mortality, the frequency of clinically amyopathic DM (CADM), the prevalence of mediastinal emphysema, periungual erythema and mechanicfs hand than patients with chronic ILD. Twenty-four out of 42 cytokines/chemokines, anti-MDA5 antibody, ferritin and IFN- alpha were available for further analyses. Patients with RPILD had significantly higher serum levels of 5 cytokines (IL-15, IL-6, CCL7, CXCL10 and VCAM-1), anti-MDA5 antibody and ferritin than patients with chronic ILD patients whereas CCL-22 was significantly low in RPILD patients. We found that IL15 was most significant cytokine to distinguish patients with RPILD from patients with chronic ILD using random forest analysis (Fig. 1). Additionally, we found that anti-MDA5 antibody, IL-15, TNF- alpha, CXCL-8, CCL-22 and IL-RA were the best combination to distinguish patients with RPILD from patients with chronic ILD (sensitivity: 95%, specificity: 88.5%, accuracy: 91.3%).
Conclusion: Our data for the first time identify the combinational serum biomarkers to predict PM/DM patients complicated with RPILD.
To cite this abstract in AMA style:Shimizu T, Koga T, Horai Y, Fujikawa K, Endo Y, Tsuji S, Takatani A, Umeda M, Fukui S, Sumiyoshi R, Nishino A, Kawashiri S, Iwamoto N, Igawa T, Ichinose K, Tamai M, Sakamoto N, Nakamura H, Origuchi T, Mukae H, Kuwana M, Kawakami A. Multiple Serum Cytokine and Chemokine Profiling to Identify Combinational Biomarkers Toward Patients of Polymyositis/Dermatomyositis Complicated with Rapidly Progressive Interstitial Lung Disease [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/multiple-serum-cytokine-and-chemokine-profiling-to-identify-combinational-biomarkers-toward-patients-of-polymyositisdermatomyositis-complicated-with-rapidly-progressive-interstitial-lung-disease/. Accessed October 1, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/multiple-serum-cytokine-and-chemokine-profiling-to-identify-combinational-biomarkers-toward-patients-of-polymyositisdermatomyositis-complicated-with-rapidly-progressive-interstitial-lung-disease/