Neopterin is primarily synthesized and released by activated macrophages/monocytes upon stimulation with interferon-gamma and is considered as a marker for macrophage activation. This study aimed to analyze the serum levels of neopterin in patients with dermatomyositis (DM) in association with clinical manifestations, laboratory data and patient prognosis. One hundred and eighty-two consecutive DM patients and 30 healthy controls were retrospectively enrolled into the study. Serum levels of neopterin were significantly increased in DM patients compared to healthy controls (P < 0 center dot 001). High serum neopterin levels were associated with anti-melanoma differentiation-associated gene (MDA5) antibody, rapidly progressive interstitial lung disease (RP-ILD) and characteristic DM cutaneous involvement. Longitudinal assessment of serum samples revealed that the serum neopterin levels were closely correlated with disease severity (beta = 30 center dot 24, P < 0 center dot 001). In addition, a significant increase in serum neopterin concentration of non-survivors was observed when compared to that of survivors (P < 0 center dot 001). Receiver operator characteristic curves showed that serum neopterin could distinguish non-survivors and survivors at an optimal cut-off level of 22 center dot 1 nmol/l with a sensitivity and specificity of 0 center dot 804 and 0 center dot 625, respectively (P < 0 center dot 001). Kaplan-Meier survival curves revealed that DM patients with serum neopterin > 22 center dot 1 nmol/l had a significantly higher mortality compared to the patient group with serum neopterin < 22 center dot 1 nmol/l (log-rank P < 0 center dot 001). Multivariate regression analysis identified high serum neopterin concentration to be an independent risk factor for poor prognosis in DM (adjusted hazard ratio = 4 center dot 619, 95% confidence interval = 2 center dot 092-10 center dot 195, P < 0 center dot 001). In conclusion, increased serum levels of neopterin were significantly associated with RP-ILD and reduced survival in DM patients, suggesting it as a promising biomarker in disease evaluation of DM.
基金：
National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81701615, 81571603, 81971531]; Beijing Municipal Science & Technology CommissionBeijing Municipal Science & Technology Commission [Z181100001718063, Z171100001017208]
第一作者单位：[1]Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China–Japan Friendship Hospital, Beijing, China
通讯作者：
通讯机构：[1]Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China–Japan Friendship Hospital, Beijing, China[*1]Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China–Japan Friendship Hospital, Beijing 100029, China
推荐引用方式(GB/T 7714)：
Peng Q. -L.,Zhang Y. -M.,Liang L.,et al.A high level of serum neopterin is associated with rapidly progressive interstitial lung disease and reduced survival in dermatomyositis[J].CLINICAL and EXPERIMENTAL IMMUNOLOGY.2020,199(3):314-325.doi:10.1111/cei.13404.
APA：
Peng, Q. -L.,Zhang, Y. -M.,Liang, L.,Liu, X.,Ye, L. -F....&Wang, G. -C..(2020).A high level of serum neopterin is associated with rapidly progressive interstitial lung disease and reduced survival in dermatomyositis.CLINICAL and EXPERIMENTAL IMMUNOLOGY,199,(3)
MLA：
Peng, Q. -L.,et al."A high level of serum neopterin is associated with rapidly progressive interstitial lung disease and reduced survival in dermatomyositis".CLINICAL and EXPERIMENTAL IMMUNOLOGY 199..3(2020):314-325
