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Successful classification of macrophage-mannose receptor CD206 in severity of anti-MDA5 antibody positive dermatomyositis associated ILD.
Rheumatology (Oxford) 2019; 58(12):2143-2152R

Abstract

OBJECTIVES

Macrophage-mannose receptor, CD206, is a marker of alternatively activated macrophages. Activated macrophages play key roles in DM. Interstitial lung disease (ILD) is a leading cause of mortality in patients with DM/clinically amyopathic DM (CADM). In particular, patients with the anti-melanoma differential gene 5 antibody (MDA5) frequently develop fatal rapid progressive ILD. This study aimed to evaluate the clinical implications of alternatively activated macrophages in patients with CADM/DM-ILD with anti-MDA5 antibody (MDA5-CADM/DM-ILD).

METHODS

We measured serum concentrations of soluble CD206 (sCD206) in 33 patients with MDA5-CADM/DM-ILD and 36 age- and sex-matched control subjects. Expression levels of CD206 in the lungs from MDA5-CADM/DM-ILD were also examined.

RESULTS

Patients with MDA5-CADM/DM-ILD had higher levels of sCD206 than those in controls (P < 0.0001). Of the 33 patients, 10 MDA5-CADM/DM-ILD patients developed fatal respiratory failure. Concentrations of sCD206 in patients with fatal ILD cases were significantly higher than those in the survivors, and increased sCD206 levels were associated with a higher mortality rate (Log-rank test, P = 0.0009). Age- and gender-adjusted logistic regression analyses showed that sCD206 was an independent prognostic factor for MDA5-CADM/DM-ILD. Importantly, assessment by sCD206 together with PaO2 successfully divided into three groups by their prognosis (P < 0.005, respectively). Pathological analyses showed accumulations of CD206-positive macrophages in lungs from the fatal case rather than those in the non-fatal cases.

CONCLUSIONS

Levels of serum sCD206 are increased in MDA5-CADM/DM-ILD and associated with poor prognosis. sCD206 is a potential biomarker to predict the severity of MDA5-CADM/DM-ILD.

Authors+Show Affiliations

Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Third Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31143953

Citation

Horiike, Yasuoki, et al. "Successful Classification of Macrophage-mannose Receptor CD206 in Severity of anti-MDA5 Antibody Positive Dermatomyositis Associated ILD." Rheumatology (Oxford, England), vol. 58, no. 12, 2019, pp. 2143-2152.
Horiike Y, Suzuki Y, Fujisawa T, et al. Successful classification of macrophage-mannose receptor CD206 in severity of anti-MDA5 antibody positive dermatomyositis associated ILD. Rheumatology (Oxford). 2019;58(12):2143-2152.
Horiike, Y., Suzuki, Y., Fujisawa, T., Yasui, H., Karayama, M., Hozumi, H., ... Suda, T. (2019). Successful classification of macrophage-mannose receptor CD206 in severity of anti-MDA5 antibody positive dermatomyositis associated ILD. Rheumatology (Oxford, England), 58(12), pp. 2143-2152. doi:10.1093/rheumatology/kez185.
Horiike Y, et al. Successful Classification of Macrophage-mannose Receptor CD206 in Severity of anti-MDA5 Antibody Positive Dermatomyositis Associated ILD. Rheumatology (Oxford). 2019 Dec 1;58(12):2143-2152. PubMed PMID: 31143953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful classification of macrophage-mannose receptor CD206 in severity of anti-MDA5 antibody positive dermatomyositis associated ILD. AU - Horiike,Yasuoki, AU - Suzuki,Yuzo, AU - Fujisawa,Tomoyuki, AU - Yasui,Hideki, AU - Karayama,Masato, AU - Hozumi,Hironao, AU - Furuhashi,Kazuki, AU - Enomoto,Noriyuki, AU - Nakamura,Yutaro, AU - Inui,Naoki, AU - Ogawa,Noriyoshi, AU - Suda,Takafumi, PY - 2018/12/19/received PY - 2019/04/08/revised PY - 2019/5/31/pubmed PY - 2019/5/31/medline PY - 2019/5/31/entrez KW - CD206 KW - MDA5 KW - dermatomyositis KW - interstitial lung disease KW - macrophage-mannose receptor SP - 2143 EP - 2152 JF - Rheumatology (Oxford, England) JO - Rheumatology (Oxford) VL - 58 IS - 12 N2 - OBJECTIVES: Macrophage-mannose receptor, CD206, is a marker of alternatively activated macrophages. Activated macrophages play key roles in DM. Interstitial lung disease (ILD) is a leading cause of mortality in patients with DM/clinically amyopathic DM (CADM). In particular, patients with the anti-melanoma differential gene 5 antibody (MDA5) frequently develop fatal rapid progressive ILD. This study aimed to evaluate the clinical implications of alternatively activated macrophages in patients with CADM/DM-ILD with anti-MDA5 antibody (MDA5-CADM/DM-ILD). METHODS: We measured serum concentrations of soluble CD206 (sCD206) in 33 patients with MDA5-CADM/DM-ILD and 36 age- and sex-matched control subjects. Expression levels of CD206 in the lungs from MDA5-CADM/DM-ILD were also examined. RESULTS: Patients with MDA5-CADM/DM-ILD had higher levels of sCD206 than those in controls (P < 0.0001). Of the 33 patients, 10 MDA5-CADM/DM-ILD patients developed fatal respiratory failure. Concentrations of sCD206 in patients with fatal ILD cases were significantly higher than those in the survivors, and increased sCD206 levels were associated with a higher mortality rate (Log-rank test, P = 0.0009). Age- and gender-adjusted logistic regression analyses showed that sCD206 was an independent prognostic factor for MDA5-CADM/DM-ILD. Importantly, assessment by sCD206 together with PaO2 successfully divided into three groups by their prognosis (P < 0.005, respectively). Pathological analyses showed accumulations of CD206-positive macrophages in lungs from the fatal case rather than those in the non-fatal cases. CONCLUSIONS: Levels of serum sCD206 are increased in MDA5-CADM/DM-ILD and associated with poor prognosis. sCD206 is a potential biomarker to predict the severity of MDA5-CADM/DM-ILD. SN - 1462-0332 UR - https://www.unboundmedicine.com/medline/citation/31143953/Successful_classification_of_macrophage_mannose_receptor_CD206_in_severity_of_anti_MDA5_antibody_positive_dermatomyositis_associated_ILD_ L2 - https://academic.oup.com/rheumatology/article-lookup/doi/10.1093/rheumatology/kez185 DB - PRIME DP - Unbound Medicine ER -