Successful classification of macrophage-mannose receptor CD206 in severity of anti-MDA5 antibody positive dermatomyositis associated ILD.

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: Yasuoki Horiike, Yuzo Suzuki, Tomoyuki Fujisawa, Hideki Yasui, Masato Karayama, Hironao Hozumi, Kazuki Furuhashi, Noriyuki Enomoto, Yutaro Nakamura, Naoki Inui, Noriyoshi Ogawa, Takafumi Suda
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 58 Issue 12 Pg. 2143-2152 (12 01 2019) ISSN: 1462-0332 [Electronic] England
• PMID: 31143953 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Autoantibodies
• Lectins, C-Type
• Mannose Receptor
• Mannose-Binding Lectins
• Receptors, Cell Surface
• IFIH1 protein, human
• Interferon-Induced Helicase, IFIH1

Topics

• Aged
• Autoantibodies (immunology)
• Dermatomyositis (complications, immunology, metabolism)
• Female
• Humans
• Interferon-Induced Helicase, IFIH1 (immunology)
• Lectins, C-Type (metabolism)
• Logistic Models
• Lung (metabolism, pathology)
• Lung Diseases, Interstitial (etiology, metabolism)
• Macrophages (metabolism, pathology)
• Male
• Mannose Receptor
• Mannose-Binding Lectins (metabolism)
• Middle Aged
• Prognosis
• Receptors, Cell Surface (metabolism)
• Respiratory Insufficiency (etiology, metabolism, mortality)
• Retrospective Studies