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The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM

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Title: The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM
Authors: Koga, Tomohiro / Fujikawa, Keita / Horai, Yoshiro / Okada, Akitomo / Kawashiri, Shin-ya / Iwamoto, Naoki / Suzuki, Takahisa / Nakashima, Yoshikazu / Tamai, Mami / Arima, Kazuhiko / Yamasaki, Satoshi / Nakamura, Hideki / Origuchi, Tomoki / Hamaguchi, Yasuhito / Fujimoto, Manabu / Ishimatsu, Yuji / Mukae, Hiroshi / Kuwana, Masataka / Kohno, Shigeru / Eguchi, Katsumi / Aoyagi, Kiyoshi / Kawakami, Atsushi
Issue Date: Jul-2012
Publisher: Oxford University Press
Citation: Rheumatology, 51(7), pp.1278-1284; 2012
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: Anti-MDA5 Ab / CADM / RPILD
URI: http://hdl.handle.net/10069/29871
ISSN: 14620324
DOI: 10.1093/rheumatology/ker518
Rights: © The Author 2012. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. / This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Rheumatology following peer review. The definitive publisher-authenticated version Rheumatology, 51 (7), art. no. ker518, pp. 1278-1284. is available online at: http://dx.doi.org/10.1093/rheumatology/ker518.
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/29871

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