Cytokeratin 19 fragment is associated with severity and poor prognosis of interstitial lung disease in anti-MDA5 antibody-positive dermatomyositis. (27th January 2021)

• Record Type: Journal Article
• Authors: Gui, Xianhua; Ma, Miao; Ding, Jingjing; Shi, ShenYun; Xin, Xiaoyan; Qiu, Xiaohua; Zhang, Yingwei; Qiu, Yuying; Cao, Min; Huang, Mei; Cao, Mengshu; Dai, Jinghong; Cai, Hourong; Xiao, Yonglong
• Is Part Of: Rheumatology. Volume 60:Number 8(2021)
• Page Start: 3913
• Page End: 3922
• Publication Date: 2021-01-27
• Subjects: cytokeratin 19 fragment -- dermatomyositis -- anti-melanoma differentiation-associated gene -- soluble CD206 -- acute/subacute interstitial pneumonia -- chronic interstitial pneumonia; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keaa843
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: In the present study, we aimed to assess the clinical significance of cytokeratin 19 fragment (CYFRA21-1) in patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive DM-interstitial lung disease (MDA5-DM-ILD). Methods: A total of 73 MDA5-DM-ILD patients were retrospectively analysed in this work. Their clinical characteristics, including clinical manifestations, laboratory findings, peripheral blood lymphocyte subsets and lung function, were compared between patients with acute/subacute interstitial pneumonia (A/SIP) and chronic interstitial pneumonia (CIP). The level of serum CYFRA21-1 was also compared between the above-mentioned two groups of patients, and its association with the clinical features and mortality of MDA5-DM-ILD was also evaluated. Results: Of the 73 MDA5-DM-ILD patients, 26 patients exhibited the A/SIP pattern. The level of serum CYFRA21-1 was higher in MDA5-DM patients with A/SIP compared with the CIP group ( P = 0.009). Lower oxygenation index (OI), CD3 + CD4 + T cell counts and percentage of CD3 + CD4 + cells were also observed in MDA5-DM patients with A/SIP compared with the CIP group. Higher serum CYFRA21-1, lower OI, and lower zone consolidation were associated with a higher risk of A/SIP in MDA5-DM-ILD. In addition, 38 decedents with MDA5-DM-ILD exhibited a greater level of CYFRA21-1 compared with 35 survivors ( P < 0.001). Furthermore, it was a prognostic factor and also associated with a higher mortality rate (log-rank test, P < 0.001). Conclusions: CYFRA21-1 could be a useful serum indicator associated with occurrence of A/SIP in MDA5-DM-ILD. Moreover, it was associated with a poor survival in MDA5-DM-ILD patients.