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Surfactant protein D is associated with 3-month mortality of anti-MDA5 antibody-interstitial lung disease

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11

 

  1. Department of Pulmonary and Critical Care Medicine, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  2. Department of Pulmonary and Critical Care Medicine, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  3. Department of Pulmonary and Critical Care Medicine, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  4. Department of Pulmonary and Critical Care Medicine, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  5. Department of Pulmonary and Critical Care Medicine, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  6. Department of Radiology, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  7. Department of Pathology, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  8. Department of Pathology, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  9. Department of Pathology, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  10. Department of Pulmonary and Critical Care Medicine, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China.
  11. Department of Pulmonary and Critical Care Medicine, Nanjing University Medical School Affiliated Drum Tower Hospital, Nanjing, Jiangsu, China. daijinghong@nju.edu.cn

CER12725
2020 Vol.38, N°6
PI 1068, PF 1074
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PMID: 31994487 [PubMed]

Received: 01/09/2019
Accepted : 03/12/2019
In Press: 28/01/2020
Published: 03/12/2020

Abstract

OBJECTIVES:
To investigate the associations between serum levels of matrix metalloproteinase 7 (MMP7), surfactant protein D (SPD), interleukin 18 (IL-18) and chemokine ligand 18 (CCL18) with dermatomyositis and polymyositis-associated interstitial lung disease (DM/PM-ILD) and evaluate their prognostic values in the disease.
METHODS:
Seventy-eight patients with multiple disciplinary team diagnosis of DM/PM-ILD were enrolled and classified as anti-melanoma differentiation-associated protein 5 antibody (MDA5)-ILD, anti-synthetase antibodies (ARS)-ILD and other antibodies-ILD upon autoantibodies profiles. Clinical data were collected and serum levels of four biomarkers were analysed. The primary endpoint was 3-month mortality. The cut-off values of biomarkers for mortality were figured out by receiver operating characteristic (ROC) analysis. Cox regression was performed to evaluate predictive values.
RESULTS:
Serum levels of MMP7 (p=0.036), SPD (p<0.001), IL-18 (p<0.001) and CCL18 (p<0.001) in patients with DM/PM-ILD were significantly higher than healthy controls with levels of MMP7 (p=0.029) and SPD (p=0.029) in patients with MDA5-ILD significantly lower than patients with ARS-ILD. The 3-month mortality in MDA5-ILD was 54.5% (12/22). Multivariate analysis showed that age (p=0.001, HR 1.151, 95% CI 1.063–1.247) and an increased level of SPD (>75.90ng/ml, p=0.005, HR 16.411, 95% CI 2.369–113.711) were significant predictors for 3-month mortality in patients with MDA5-ILD.
CONCLUSIONS:
Elevated serum biomarkers were associated with DM/PM-ILD with differential levels between MDA5-ILD and ARS-ILD. Age and an increased SPD had prognostic values for predicting short-term mortality in patients with MDA5-ILD. Our study was important in providing a clue for understanding the classification and prognosis of DM/PM-ILD.

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