Analysis of characteristics related to interstitial lung disease or pulmonary hypertension in patients with dermatomyositis

Clin Respir J. 2023 Dec;17(12):1328-1340. doi: 10.1111/crj.13720. Epub 2023 Nov 20.

Abstract

Introduction: Dermatomyositis (DM) is often associated with interstitial lung disease (ILD) or pulmonary hypertension (PH). The aim of this study was to investigate the clinical characteristics of DM patients with ILD or PH.

Methods: This study retrospectively analysed the clinical characteristics of 372 patients with DM, including cytokines, lymphocyte subsets, immunoglobulin and complement. The DM patients were divided into different groups according to whether complicated with ILD, PH or anti-melanoma differentiation-associated gene 5 antibodies (MDA5). A qualitative and quantitative data analysis was performed.

Results: IgG, IgA and IgM in the DM-associated ILD (ILD-DM) were higher than that of the DM non-complicating ILD (Non-ILD-DM) (p = 0.022, 0.002 and 0.029, respectively). Meanwhile, IL-6 (p = 0.008) and IL-10 (p = 0.001) were increased in the DM-associated PH (PH-DM) than in the DM non-complicating PH (Non-PH-DM), while IL-17 (p = 0.004), double positive (DP) cell ratio and B lymphocyte ratio were reduced in the PH-DM. Moreover, the incidence of ILD and levels of C4 were higher in the DM with MDA5 (MDA5+ DM) than that of the DM without MDA5.

Conclusion: ILD-DM has higher IgG, IgA and IgM than that of Non-ILD-DM. PH-DM has higher IL-6, IL-10 and lower IL-17, DP cell ratio and B lymphocyte ratio than that of Non-PH-DM.

Keywords: anti-melanoma differentiation-associated gene 5 antibodies; dermatomyositis; interstitial lung disease; pulmonary hypertension.

MeSH terms

  • Autoantibodies
  • Dermatomyositis* / complications
  • Humans
  • Hypertension, Pulmonary* / complications
  • Hypertension, Pulmonary* / etiology
  • Immunoglobulin A
  • Immunoglobulin G
  • Immunoglobulin M
  • Interferon-Induced Helicase, IFIH1
  • Interleukin-10
  • Interleukin-17
  • Interleukin-6
  • Lung Diseases, Interstitial* / complications
  • Lung Diseases, Interstitial* / epidemiology
  • Prognosis
  • Retrospective Studies

Substances

  • Interleukin-10
  • Interleukin-17
  • Interleukin-6
  • Autoantibodies
  • Interferon-Induced Helicase, IFIH1
  • Immunoglobulin A
  • Immunoglobulin G
  • Immunoglobulin M