The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM
Top Cited Papers
Open Access
- 29 February 2012
- journal article
- research article
- Published by Oxford University Press (OUP) in Rheumatology
- Vol. 51 (7), 1278-1284
- https://doi.org/10.1093/rheumatology/ker518
Abstract
Objective. Interstitial lung disease (ILD), especially rapidly progressive ILD (RPILD), is a major poor prognostic factor in patients with DM. We investigated the association of anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab) with clinical characteristics and mortality in Japanese patients with DM. Methods. Seventy-nine DM patients, comprising 58 classic DM and 21 clinically amyopathic DM (CADM) patients, were enrolled. Serum Abs were screened by immunoprecipitation assays, and an immunosorbent assay (ELISA) was used for MDA5. The relationships of clinical characteristics and mortality with each Ab were investigated. Results. Anti-MDA5 Ab was detected in 17 patients. Anti-clinically amyopathic DM 140 kDa polypeptide Abs (anti-CADM-140 Abs) were found in 16 of the 17 anti-MDA5 Ab+ patients. Skin ulcers, palmar papules, CADM, RPILD and mediastinal emphysema were widely distributed in anti-MDA5 Ab+ patients. Mortality at 6 months as well as 5 years was also significantly higher in anti-MDA5 Ab+ patients than in anti-MDA5 Ab− patients. In a multivariable Cox regression analysis, mortality was independently associated with anti-MDA5 Ab (relative hazard 6.33; 95% CI 1.43, 28.0). All of the deaths in anti-MDA5 Ab+ patients were attributed to respiratory failure of RPILD; however, RPILD did not worsen in any of the anti-MDA5 Ab+ patients who survived the first 6 months. Conclusion. The presence of anti-MDA5 Ab identifies the characteristic skin, musculoskeletal, pulmonary and prognostic features in patients with DM. In addition, anti-MDA5 Ab seems to predict a group of patients with CADM-complicated fatal RPILD.Keywords
This publication has 22 references indexed in Scilit:
- The RIG-I-like receptor IFIH1/MDA5 is a dermatomyositis-specific autoantigen identified by the anti-CADM-140 antibodyRheumatology, 2009
- Clinical Differences Between Interstitial Lung Disease Associated With Clinically Amyopathic Dermatomyositis and Classic DermatomyositisChest, 2009
- Clinical and Serologic Characterization of an Argentine Pediatric Myositis Cohort: Identification of a Novel Autoantibody (anti-MJ) to a 142-kDa ProteinThe Journal of Rheumatology, 2009
- RNA helicase encoded by melanoma differentiation–associated gene 5 is a major autoantigen in patients with clinically amyopathic dermatomyositis: Association with rapidly progressive interstitial lung diseaseArthritis & Rheumatism, 2009
- Association of distinct clinical subsets with myositis‐specific autoantibodies towards anti‐155/140‐kDa polypeptides, anti‐140‐kDa polypeptides, and anti‐aminoacyl tRNA synthetases in Japanese patients with dermatomyositis: a single‐centre, cross‐sectional studyScandinavian Journal of Rheumatology, 2009
- Identification of a novel autoantibody reactive with 155 and 140 kDa nuclear proteins in patients with dermatomyositis: an association with malignancyRheumatology, 2006
- Anti-aminoacyl-tRNA synthetase antibodies in clinical course prediction of interstitial lung disease complicated with idiopathic inflammatory myopathiesAutoimmunity, 2006
- Autoantibodies to a 140‐kd polypeptide, CADM‐140, in Japanese patients with clinically amyopathic dermatomyositisArthritis & Rheumatism, 2005
- The Dermatomyositis-Specific Autoantigen Mi2 Is a Component of a Complex Containing Histone Deacetylase and Nucleosome Remodeling ActivitiesCell, 1998
- Epitope analysis of the major reactive region of the 100‐kd protein of PM‐Scl autoantigenArthritis & Rheumatism, 1996