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Evaluation and validation of the prognostic value of anti-MDA5 IgG subclasses in dermatomyositis-associated interstitial lung disease

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单位: [1]Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital. Yinghua East Road, Chaoyang District, Beijing, 100029, China [2]Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China. [3]Department of nephrology, Beijing Friendship Hospital, Capital Medical University. Yong'an Road, Xicheng District, Beijing, 100050, China.
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关键词: DM interstitial lung disease anti-MDA5 IgG subclasses prognosis

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Objective To investigate the association between the anti-melanoma differentiation associated gene 5 (MDA5) IgG subclasses and prognosis of patients with dermatomyositis (DM)-associated interstitial lung disease (ILD). Methods This retrospective study included 122 anti-MDA5 positive DM-ILD patients admitted from October 2017 to October 2020 as training cohort, and additional 68 patients from August 2014 to September 2017 as validation cohort. The levels of anti-MDA5 total IgG and IgG subclasses were measured using in-house enzyme-linked immunosorbent assays, and analysed in association with the patient prognosis. Results In the training cohort, the concentrations of anti-MDA5 IgG1 and IgG3 in non-survivors were significantly higher than in survivors (P < 0.05), whereas there were no significant differences in the IgG2 and IgG4 levels. Kaplan-Meier survival analysis revealed that the levels of anti-MDA5 total IgG, IgG1 and IgG3 were associated with mortality (P < 0.05). Multivariate analysis revealed anti-MDA5 IgG1 >13 U/ml and anti-MDA5 IgG3 >11 U/ml were independent risk factors for death of DM-ILD patients (P < 0.05). Anti-MDA5 IgG1 was confirmed as an independent risk factor in the validation cohort, while anti-MDA5 IgG3 was not. Anti-MDA5 IgG1 showed greater discriminable power for patient prognosis (Youden index 0.494) than anti-MDA5 total IgG, IgG3, or the combination of IgG1 and IgG3 (Youden index 0.356, 0.32 and 0.447, respectively). Conclusion Anti-MDA5 IgG1 and IgG3 are significantly associated with poor prognosis in DM-ILD patients, and anti-MDA5 IgG1 is more efficient as a prognostic biomarker in DM-ILD patients.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 2 区 风湿病学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 风湿病学
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出版当年[2020]版:
Q1 RHEUMATOLOGY
最新[2023]版:
Q1 RHEUMATOLOGY

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第一作者单位: [1]Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital. Yinghua East Road, Chaoyang District, Beijing, 100029, China [2]Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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通讯机构: [1]Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital. Yinghua East Road, Chaoyang District, Beijing, 100029, China [2]Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China. [*1]Department of Rheumatology, Key Lab of Myositis, China-Japan Friendship Hospital. Graduate School of Peking Union Medical College, Beijing, 100730, China.Yinghua East Road, Chaoyang District, Beijing, China.
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