Serum interleukin 6 levels as a useful prognostic predictor of clinically amyopathic dermatomyositis with rapidly progressive interstitial lung disease

Nara, Mizuho; Komatsuda, Atsushi; Omokawa, Ayumi; Togashi, Masaru; Okuyama, Shin; Sawada, Kenichi; Wakui, Hideki

doi:10.3109/14397595.2013.844390

Cited by 36 publications

(23 citation statements)

References 16 publications

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“…Upregulated IL-6 production stimulated by PGRN [27,28,45] may be related to elevation of CRP in DM patients with A/SIP. Serum IL-6 levels were significantly higher in dead than alive CADM patients with ILD [33] and were reported to be candidate biomarkers for disease activity in DM [32] and SLE [46]. Because TLR9 is highly expressed in DM [29-31] and SLE [47], upregulated IL-6 production stimulated by PGRN via TLR9 may be a common pathogenesis of DM and SLE.…”

Section: Discussionmentioning

confidence: 99%

Serum progranulin levels are elevated in dermatomyositis patients with acute interstitial lung disease, predicting prognosis

Tanaka¹,

Tsukamoto²,

Mitoma³

et al. 2015

Arthritis Res Ther

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Section: Discussionmentioning

confidence: 99%

Serum progranulin levels are elevated in dermatomyositis patients with acute interstitial lung disease, predicting prognosis

Tanaka¹,

Tsukamoto²,

Mitoma³

et al. 2015

Arthritis Res Ther

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“…Positive anti-MDA5 antibody, high serum ferritin level, and high serum IL-6 level before treatment were previously reported as prognostic factors of DM-IP 16–21, 29 . Although serum IL-6 was not examined in this study, the anti-MDA5 antibody-positive rate was higher in the death group, similar to findings in previous reports.…”

Section: Discussionmentioning

confidence: 80%

“…Interferon-α, tumor necrosis factor-α, interleukin (IL)-6, IL-10, and IL-18 were related to disease activity 20, 26–32 . Patients with a high serum IL-6 level had a poor prognosis 29 . Chemokines induce directed chemotaxis and activation of various leukocytes and relate to the pathophysiological conditions of several diseases including DM-IP.…”

Section: Introductionmentioning

confidence: 99%

Chemokine profiles of interstitial pneumonia in patients with dermatomyositis: a case control study

Oda

Kotani

Takeuchi

et al. 2017

Sci Rep

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Chemokines play an important role in the pathophysiology of dermatomyositis (DM) with interstitial pneumonia (IP). However, the relation between chemokines and the disease activity or prognosis of DM-IP has not been elucidated. We evaluated the serum C-C motif chemokine ligand (CCL) 2, Th1 chemokines (C-X-C motif chemokine ligand [CXCL] 9, CXCL10, CXCL11), and Th2 chemokine (CCL17) profiles of 30 patients, and examined the relation between these chemokines and the disease activity or prognosis of DM-IP. Initial serum CCL2 level was higher in the death group (P = 0.007). To determine the cut-off points effective as poor prognostic factors of DM-IP, ROC curve analysis was carried out on initial serum CCL2 level. The value that maximized the area under the ROC curve was 894 pg/mL (sensitivity: 100%, specificity: 70.8%). Serum CCL2, CXCL9, CXCL10, and CXCL11 levels were lower at 2 weeks after treatment initiation than before treatment. Serum CCL2, CXCL10, and CXCL11 levels at 2 weeks after treatment initiation were higher in the death group. Serum levels of chemokines such as CCL2, CXCL10, and CXCL11 may be possible biomarkers of disease activity and prognosis in DM-IP, and serum CCL2 level may be useful when deciding initial treatment.

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“…A high KL–6 level, anti-MDA5 Ab positivity, high serum levels of ferritin, IL–6, IL–10, and IL–8, and a high level of AaDO 2 have been reported as serological factors in DM-IP that indicate a poor prognosis [ 33 – 35 , 36 – 39 ]. Sato et al reported that anti-MDA5 Ab is a useful prognostic indicator of DM-IP [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…In fact, the patients in all of the fatal cases in our study were anti-MDA5 Ab-positive. Nara et al reported that the serum IL–6 level was 9 pg/ml or higher in all 6 patients with CADM-IP who died of IP, whereas it was lower than 9 ng/ml in 5 of 6 survivors [ 39 ]. It has also been reported that in patients with DM-IP, those with a serum ferritin level ≥ 1500 ng/ml, or those with a serum ferritin level ≥ 600 ng/ml plus AaDO 2 ≥ 45 mmHg, have poor prognoses [ 8 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Increased Serum LIGHT Levels Correlate with Disease Progression and Severity of Interstitial Pneumonia in Patients with Dermatomyositis: A Case Control Study

et al. 2015

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BackgroundActivated CD8+ T cells play an important role in the pathogenesis of dermatomyositis (DM) with interstitial pneumonia (IP). Serum CD8+ T-cell activator, LIGHT, and Th1/Th2/Th17 cytokines were measured in DM-IP patients and compared with clinical parameters to investigate their usefulness.MethodsThe correlations between the clinical findings and serum LIGHT and Th1/Th2/Th17 cytokine levels were investigated in 21 patients with DM-IP (14 with rapidly progressive IP [RPIP] and 7 with chronic IP [CIP], including 4 fatal cases of IP).ResultsThe median serum LIGHT level was 119 (16–335.4) pg/ml, which was higher than that in healthy control subjects and DM patients without IP. The median serum IL–6 level was 14.7 (2.4–154.5) pg/ml (n = 13). The other cytokines were detected in only a few patients. The median serum LIGHT level in DM-RPIP patients (156 [49.6–335.4] pg/ml) was significantly higher than that in DM-CIP patients (94.3 [16–164.2] pg/ml) (P = 0.02). The serum IL–6 level did not correlate with either progression or outcome of DM-IP. ROC curve analysis determined a serum LIGHT level of ≥120 pg/ml to be the cut-off value for the rapid progression of DM-IP. Serum LIGHT levels correlated significantly with %DLco (R = 0.55, P = 0.04) and total ground-glass opacity scores (R = 0.72, P = 0.0002). The serum LIGHT level significantly decreased to 100.5 (12.4–259.3) pg/ml 4 weeks after treatment initiation (P = 0.04).ConclusionsThe serum LIGHT level may be a promising marker of disease progression and severity in patients with DM-IP.

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Serum interleukin 6 levels as a useful prognostic predictor of clinically amyopathic dermatomyositis with rapidly progressive interstitial lung disease

Abstract: Serum IL-6 levels may predict the prognosis of CADM patients with RP-ILD. The intensity of immunosuppressive treatment can be decided according to serum IL-6 levels at an early phase of the disease.

Cited by 36 publications

References 16 publications

Serum progranulin levels are elevated in dermatomyositis patients with acute interstitial lung disease, predicting prognosis

Serum progranulin levels are elevated in dermatomyositis patients with acute interstitial lung disease, predicting prognosis

Chemokine profiles of interstitial pneumonia in patients with dermatomyositis: a case control study

Increased Serum LIGHT Levels Correlate with Disease Progression and Severity of Interstitial Pneumonia in Patients with Dermatomyositis: A Case Control Study

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