Chemokine profiles of interstitial pneumonia in patients with dermatomyositis: a case control study

Katsuhiro Oda,Yasuichiro Nishimura,Shuzo Yoshida,Takuya Kotani,Takeshi Shoda,Shigeki Makino,Tohru Takeuchi,Kentaro Isoda,Takaaki Ishida

doi:10.1038/s41598-017-01685-5

Katsuhiro Oda, Yasuichiro Nishimura + Show 7 more

Open Access

https://doi.org/10.1038/s41598-017-01685-5

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Journal: Scientific Reports	Publication Date: May 9, 2017
Citations: 24	License type: open-access

Affiliation: Osaka Medical and Pharmaceutical University

Abstract

Chemokines play an important role in the pathophysiology of dermatomyositis (DM) with interstitial pneumonia (IP). However, the relation between chemokines and the disease activity or prognosis of DM-IP has not been elucidated. We evaluated the serum C-C motif chemokine ligand (CCL) 2, Th1 chemokines (C-X-C motif chemokine ligand [CXCL] 9, CXCL10, CXCL11), and Th2 chemokine (CCL17) profiles of 30 patients, and examined the relation between these chemokines and the disease activity or prognosis of DM-IP. Initial serum CCL2 level was higher in the death group (P = 0.007). To determine the cut-off points effective as poor prognostic factors of DM-IP, ROC curve analysis was carried out on initial serum CCL2 level. The value that maximized the area under the ROC curve was 894 pg/mL (sensitivity: 100%, specificity: 70.8%). Serum CCL2, CXCL9, CXCL10, and CXCL11 levels were lower at 2 weeks after treatment initiation than before treatment. Serum CCL2, CXCL10, and CXCL11 levels at 2 weeks after treatment initiation were higher in the death group. Serum levels of chemokines such as CCL2, CXCL10, and CXCL11 may be possible biomarkers of disease activity and prognosis in DM-IP, and serum CCL2 level may be useful when deciding initial treatment.

Highlights

Dermatomyositis (DM) is one of the idiopathic inflammatory myopathies characterized by inflammation of skin and muscle[1, 2]
No significant differences were observed in age, sex, frequency of Clinically amyopathic dermatomyositis (CADM) and acute/subacute IP (A/SIP), and time from the appearance of respiratory symptoms to treatment initiation
There were no significant differences in the anti-aminoacyl-tRNA synthetase (ARS) antibody-positive rate and in creatine kinase (CK), ALD, lactic acid dehydrogenase (LDH), C-reactive protein (CRP), Krebs von den Lungen-6 (KL-6), and ferritin levels between the two groups

Summary

Introduction

Dermatomyositis (DM) is one of the idiopathic inflammatory myopathies characterized by inflammation of skin and muscle[1, 2]. Anti-ARS antibody-positive PM/DM-IP shows a good response to immunosuppressive therapy with a good prognosis[15]. Gono et al showed that the prognosis was significantly poorer in DM-IP patients with anti-MDA5 antibody than anti-ARS antibody[17]. Previous reports revealed that several prognostic factors, including positive anti-MDA5 antibody, high serum ferritin level before treatment, high alveolar-arterial oxygen difference (AaDO2), low % forced vital capacity, and high total ground-glass opacity (GGO) score before treatment, and elevation of Krebs von den Lungen-6 (KL-6) at 2–4 weeks after the beginning of treatment, were poor prognostic factors of DM-IP16–25. Gono et al reported that high serum CXCL8 level was a poor prognostic factor of DM-IP28. The relation between these chemokines and the disease activity or prognosis of DM-IP has not been elucidated

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