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Predictive value of serum markers for the development of interstitial lung disease in patients with polymyositis and dermatomyositis: a comparative and prospective study
Author(s) -
Chen F.,
Lu X.,
Shu X.,
Peng Q.,
Tian X.,
Wang G.
Publication year - 2015
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12754
Subject(s) - medicine , polymyositis , dermatomyositis , interstitial lung disease , gastroenterology , prospective cohort study , surfactant protein d , predictive value , lung , receptor , innate immune system
Background Interstitial lung disease ( ILD ) is one of the most common and devastated complication of polymyositis/dermatomyositis ( PM / DM ). Several studies have focused on serum biomarkers for ILD in PM / DM patients; however, there have been no prospective studies. Aim To explore and compare the predictive value of four serum markers for the development of ILD in patients with PM / DM . Methods One hundred adult PM / DM patients were included in this prospective clinical study at baseline. Forty‐four PM / DM patients without ILD were followed up for 1 year. Fifty‐six PM / DM patients with ILD were treated and followed up for 2 months. Serum samples were analysed for the levels of Krebs von den Lungen‐6 ( KL ‐6), monocyte chemotactic protein‐1 ( MCP ‐1), surfactant protein‐ A and D ( SP ‐ A , SP ‐ D ). Results Serum KL ‐6 (1542.8 ± 760.8 U/mL) ( P < 0.001), MCP ‐1 (1870 ± 1590 pg/mL) ( P = 0.014), SP ‐A (56 ± 28 ng/mL) ( P < 0.001) and SP ‐ D (230 ± 196 ng/mL) ( P < 0.001) were significantly elevated in PM / DM patients with ILD compared with those in the patients without ILD ( KL ‐6 429 ± 105.8 U/mL; MCP ‐1 1349 ± 1303 pg/mL; SP ‐ A 34 ± 26 ng/mL; SP ‐ D 96 ± 63 ng/mL). In PM / DM patients without ILD who were followed up for 1 year, KL ‐6 presented the highest predictive value among single markers. In patients who were treated and followed up, KL ‐6 concentrations increased with the progression of ILD and decreased along with the improvement of ILD . Conclusion Considering the ability of KL ‐6 for predicting the onset of ILD and monitoring the treatment response of ILD in PM / DM patients, it may be of great significance for clinical practice, and the prognosis of patients may be substantially improved if serum KL ‐6 was regularly monitored.