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Peripheral blood immunophenotypic diversity in patients with anti-MDA5+ dermatomyositis and its impact on prognosis
Y. Zhang1, R. Liu2, W. Hu3, T. Li4, T. Li5, W. Guan6, L. Zhang7, Y. He8, C. Lian9, J. Sun10, S. Liu11, P. Zhang12
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Respiratory Intensive Care Unit, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 15838035509@163.com
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China. fccliusy2@zzu.edu.cn
- Department of Rheumatology and Clinical Immunology, the first Affiliated Hospital of Zhengzhou University, Zhengzhou, China. panpanzhang2016@163.com
CER18890
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PMID: 41511756 [PubMed]
Received: 04/05/2025
Accepted : 19/09/2025
In Press: 08/01/2026
Abstract
OBJECTIVES:
To explore the heterogeneity and the corresponding clinical significance of lymphocyte subsets in dermatomyositis patients with anti-melanoma differentiation-associated gene 5 positive autoantibody (anti-MDA5+ DM).
METHODS:
268 anti-MDA5+ DM patients and 536 gender-age matched healthy controls (HCs) were retrospectively enrolled. Patients’ clinical data, serological parameters, peripheral blood lymphocyte subsets, imagological examinations, treatment regimens and follow-up were collected. Cluster analysis based on peripheral blood lymphocyte subsets was conducted in anti-MDA5+ DM patients.
RESULTS:
The absolute number of CD3+ T lymphocytes, CD3+CD4+ T cells, CD3+CD8+ T cells, CD3-CD19+ B cells and CD16+CD56+ NK cells were significantly reduced in anti-MDA5+ DM patients compared with HCs. The absolute counts of the above cell subsets were remarkably reduced in non-survivors compared to the survivors of anti-MDA5+ DM. Cluster analysis based on lymphocyte subsets divided anti-MDA5+ DM patients into cluster 1(n=125) and cluster 2 (n=143). Patients in cluster 1 presented with lower counts of CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, CD3-CD19+ B cells and NK cells compared with cluster 2. Notably, RP-ILD rate, three-month and six-month death rate in cluster 1 were dramatically higher than in cluster 2, p<0.001, respectively.
CONCLUSIONS:
Lymphocytes and their subsets were significantly altered in anti-MDA5+ DM patients. There was remarkable heterogeneity of lymphocyte subsets in anti-MDA5+ DM patients between survivors and non-survivors. Anti-MDA5+ DM patients were divided into two groups with distinct symptoms and survival rate by cluster analysis based on lymphocyte subsets.
