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Low positive titer of anti-melanoma differentiation-associated gene 5 antibody is not associated with a poor long-term outcome of interstitial lung disease in patients with dermatomyositis.
Respir Investig 2018; 56(6):464-472RI

Abstract

BACKGROUND

Anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5-Ab) is associated with fatal rapidly progressive interstitial lung disease (RP-ILD) in patients with dermatomyositis (DM). We attempted to clarify whether anti-MDA5-Ab is associated with long-term outcomes in patients with DM-ILD.

METHODS

Thirty-six patients with DM-ILD were retrospectively analyzed for their serum anti-MDA5-Ab by using an enzyme-linked immunosorbent assay. We analyzed the association between clinical parameters, including the serum levels of anti-MDA5-Ab and ferritin.

RESULTS

Fourteen patients (39%) were positive for anti-MDA5-Ab. The serum levels of anti-MDA5-Ab and ferritin in 7 patients with acute death were higher than those in the surviving patients. An "unclassifiable pattern" on chest computed tomography and the development of RP-ILD were also prognostic markers. The serum levels of anti-MDA5-Ab and ferritin (cut-off levels, 100 IU/mL and 899 ng/mL, respectively) were markers predictive of acute death, showing good sensitivity (86% and 83%) and specificity (97% and 100%). All 7 patients with acute death developed RP-ILD and were positive for anti-MDA5-Ab, including 6 patients with a high titer (≥100 IU/mL), whereas only 2 patients (29%) developed RP-ILD among the 7 survivors with a low titer of anti-MDA5-Ab (< 100 IU/mL). In contrast, a low positive titer of anti-MDA5-Ab was not associated with changes in pulmonary function for 2 years.

CONCLUSIONS

Although a high serum titer of anti-MDA5-Ab (≥100 IU/mL) is associated with acute death via the development of RP-ILD, outcomes in the chronic phase for patients with a low titer of anti-MDA5-Ab (< 100 IU/mL) were similar to those of patients without anti-MDA5-Ab.

Authors+Show Affiliations

Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: sakamoto_satoshi@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: okamoto_masaki@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: kaieda@med.kurume-u.ac.jp.Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: kimichan@med.kurume-u.ac.jp.Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: sn4735@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: tominaga_masaki@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: nakamura_masayuki@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: zaizen_yoshiaki@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: nouno_takashi@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: koga_takuma@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: kawayama_tomotaka@med.kurume-u.ac.jp.Department of Allergy and Rheumatology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-8603, Japan. Electronic address: kuwanam@nms.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: ida@med.kurume-u.ac.jp.Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 67, Kurume, Fukuoka 830-0011, Japan. Electronic address: hoshino@med.kurume-u.ac.jp.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30150008

Citation

Sakamoto, Satoshi, et al. "Low Positive Titer of Anti-melanoma Differentiation-associated Gene 5 Antibody Is Not Associated With a Poor Long-term Outcome of Interstitial Lung Disease in Patients With Dermatomyositis." Respiratory Investigation, vol. 56, no. 6, 2018, pp. 464-472.
Sakamoto S, Okamoto M, Kaieda S, et al. Low positive titer of anti-melanoma differentiation-associated gene 5 antibody is not associated with a poor long-term outcome of interstitial lung disease in patients with dermatomyositis. Respir Investig. 2018;56(6):464-472.
Sakamoto, S., Okamoto, M., Kaieda, S., Fujimoto, K., Nagata, S., Tominaga, M., ... Hoshino, T. (2018). Low positive titer of anti-melanoma differentiation-associated gene 5 antibody is not associated with a poor long-term outcome of interstitial lung disease in patients with dermatomyositis. Respiratory Investigation, 56(6), pp. 464-472. doi:10.1016/j.resinv.2018.07.007.
Sakamoto S, et al. Low Positive Titer of Anti-melanoma Differentiation-associated Gene 5 Antibody Is Not Associated With a Poor Long-term Outcome of Interstitial Lung Disease in Patients With Dermatomyositis. Respir Investig. 2018;56(6):464-472. PubMed PMID: 30150008.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low positive titer of anti-melanoma differentiation-associated gene 5 antibody is not associated with a poor long-term outcome of interstitial lung disease in patients with dermatomyositis. AU - Sakamoto,Satoshi, AU - Okamoto,Masaki, AU - Kaieda,Shinjiro, AU - Fujimoto,Kiminori, AU - Nagata,Shuji, AU - Tominaga,Masaki, AU - Nakamura,Masayuki, AU - Zaizen,Yoshiaki, AU - Nouno,Takashi, AU - Koga,Takuma, AU - Kawayama,Tomotaka, AU - Kuwana,Masataka, AU - Ida,Hiroaki, AU - Hoshino,Tomoaki, Y1 - 2018/08/24/ PY - 2018/02/28/received PY - 2018/07/09/revised PY - 2018/07/20/accepted PY - 2018/8/29/pubmed PY - 2018/12/12/medline PY - 2018/8/29/entrez KW - Anti-melanoma differentiation-associated gene 5 antibody KW - Autoimmune disease KW - Dermatomyositis KW - Interstitial lung disease KW - Rapidly progressive interstitial lung disease SP - 464 EP - 472 JF - Respiratory investigation JO - Respir Investig VL - 56 IS - 6 N2 - BACKGROUND: Anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5-Ab) is associated with fatal rapidly progressive interstitial lung disease (RP-ILD) in patients with dermatomyositis (DM). We attempted to clarify whether anti-MDA5-Ab is associated with long-term outcomes in patients with DM-ILD. METHODS: Thirty-six patients with DM-ILD were retrospectively analyzed for their serum anti-MDA5-Ab by using an enzyme-linked immunosorbent assay. We analyzed the association between clinical parameters, including the serum levels of anti-MDA5-Ab and ferritin. RESULTS: Fourteen patients (39%) were positive for anti-MDA5-Ab. The serum levels of anti-MDA5-Ab and ferritin in 7 patients with acute death were higher than those in the surviving patients. An "unclassifiable pattern" on chest computed tomography and the development of RP-ILD were also prognostic markers. The serum levels of anti-MDA5-Ab and ferritin (cut-off levels, 100 IU/mL and 899 ng/mL, respectively) were markers predictive of acute death, showing good sensitivity (86% and 83%) and specificity (97% and 100%). All 7 patients with acute death developed RP-ILD and were positive for anti-MDA5-Ab, including 6 patients with a high titer (≥100 IU/mL), whereas only 2 patients (29%) developed RP-ILD among the 7 survivors with a low titer of anti-MDA5-Ab (< 100 IU/mL). In contrast, a low positive titer of anti-MDA5-Ab was not associated with changes in pulmonary function for 2 years. CONCLUSIONS: Although a high serum titer of anti-MDA5-Ab (≥100 IU/mL) is associated with acute death via the development of RP-ILD, outcomes in the chronic phase for patients with a low titer of anti-MDA5-Ab (< 100 IU/mL) were similar to those of patients without anti-MDA5-Ab. SN - 2212-5353 UR - https://www.unboundmedicine.com/medline/citation/30150008/Low_positive_titer_of_anti_melanoma_differentiation_associated_gene_5_antibody_is_not_associated_with_a_poor_long_term_outcome_of_interstitial_lung_disease_in_patients_with_dermatomyositis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2212-5345(18)30196-5 DB - PRIME DP - Unbound Medicine ER -