Abstract | OBJECTIVE: To investigate the clinical features of dermatomyositis (DM) and clinically amyopathic DM (CADM) patients with the presence of anti- melanoma differentiation-associated gene 5 (anti-MDA-5) antibodies. METHODS: RESULTS: Anti-MDA-5 antibodies were detected at a significantly higher frequency in CADM patients than in DM patients (12 of 32 versus 3 of 32; P = 0.016), but were not detected in patients with other CTDs or IPF and healthy controls. Patients with a positive expression of anti-MDA-5 antibodies developed significantly more skin ulcerations (12 of 15 versus 4 of 49; P < 0.001) and interstitial lung disease (ILD; 15 of 15 versus 31 of 49 [P = 0.003]) than those without anti-MDA-5 antibodies. High-resolution computed tomography scores of the MDA-5-positive subset were increased compared with the MDA-5-negative group (mean ± SD 117.7 ± 76.3 versus 54.4 ± 50.7; P = 0.004), and the scores correlated well with anti-MDA-5 antibody levels (r(2) = 0.582, P = 0.029). The respiratory symptoms as well as skin ulcerations were dramatically improved in patients with anti-MDA-5 antibody levels <500 units/ml after treatment, whereas patients with anti-MDA-5 antibody levels >500 units/ml were resistant to the treatment and died of respiratory failure in a short period of time. CONCLUSION: Anti-MDA-5 antibody levels closely correlate with the severity of skin ulcerations, ILD, and the prognosis of the disease. Dynamic observation of serum anti-MDA-5 antibody levels would be helpful in predicting the course of ILD and facilitating better therapeutic targeting.
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Authors | Hua Cao, Meng Pan, Yanqing Kang, Qunli Xia, Xia Li, Xiaoqing Zhao, Ruofei Shi, Jianghua Lou, Min Zhou, Masataka Kuwana, Xiaoyi Ding, Jie Zheng |
Journal | Arthritis care & research
(Arthritis Care Res (Hoboken))
Vol. 64
Issue 10
Pg. 1602-10
(Oct 2012)
ISSN: 2151-4658 [Electronic] United States |
PMID | 22623119
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2012 by the American College of Rheumatology. |
Chemical References |
- Autoantibodies
- IFIH1 protein, human
- DEAD-box RNA Helicases
- Interferon-Induced Helicase, IFIH1
|
Topics |
- Adult
- Aged
- Autoantibodies
(blood, immunology)
- DEAD-box RNA Helicases
(immunology)
- Dermatomyositis
(diagnosis, immunology)
- Disease Progression
- Female
- Humans
- Interferon-Induced Helicase, IFIH1
- Male
- Middle Aged
- Prognosis
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