Title Adrenomedullin Expression Is Associated With the Severity and Poor Prognosis of Interstitial Lung Disease in Dermatomyositis Patients
Authors Ye, Lifang
Zuo, Yu
Chen, Fang
Xu, Yuetong
Zhang, Puli
Yang, Hongxia
Peng, Qinglin
Wang, Guochun
Shu, Xiaoming
Affiliation China Japan Friendship Hosp, Dept Rheumatol, Key Lab Myositis, Beijing, Peoples R China
Chinese Acad Med Sci, Peking Union Med Coll, Beijing, Peoples R China
Peking Univ, China Japan Friendship Sch Clin Med, Beijing, Peoples R China
Keywords IDIOPATHIC INFLAMMATORY MYOPATHIES
PLASMA ADRENOMEDULLIN
CLASSIFICATION
ADULT
CYTOKINES
Issue Date 2-Jun-2022
Publisher FRONTIERS IN IMMUNOLOGY
Abstract ObjectiveTo evaluate adrenomedullin mRNA levels in the peripheral blood mononuclear cells (PBMCs) of patients with dermatomyositis (DM) as well as their correlation with the severity of interstitial lung disease (ILD). MethodsA total of 41 DM patients and seven immune-mediated necrotizing myopathy (IMNM) patients were recruited, in addition to 21 healthy controls (HCs). The adrenomedullin mRNA levels in PBMCs were measured via quantitative reverse-transcription real-time polymerase chain reaction (qRT-PCR). The associations between adrenomedullin expression levels and major clinical, laboratory, pulmonary function parameters and the prognosis of patients with DM-related ILD (DM-ILD) were analyzed. Immunohistochemical analysis was performed on lung tissues of DM-ILD patients to determine adrenomedullin expression. ResultsAdrenomedullin mRNA levels in PBMCs were significantly higher in DM patients than in IMNM patients and HCs (p = 0.022 and p<0.001, respectively). Among DM patients, the levels were significantly higher in those with rapidly progressive ILD (RP-ILD) than in those with chronic ILD (p = 0.002) or without ILD (p < 0.001). The adrenomedullin mRNA levels in DM-ILD were positively correlated with serum ferritin (r =0.507, p =0.002), lactate dehydrogenase (LDH) (r =0.350, p =0.045), and lung visual analog scale (VAS) (r=0.392, p=0.021) and were negatively correlated with pulmonary function test parameters, including predicted forced vital capacity (FVC)% (r = -0.523, p = 0.025), forced expiratory volume in 1 s (FEV1)% (r = -0.539, p = 0.020), and diffusing capacity of carbon monoxide (DLco)% (r = -0.495, p = 0.036). Immunohistochemical analysis of adrenomedullin confirmed higher expression in the alveolar epithelial cells and macrophages of DM patients with RP-ILD. Among the DM patients with ILD, the six decedents exhibited higher adrenomedullin levels than the 28 survivors (p = 0.042). The cumulative survival rate was significantly lower (62.5% vs. 100%, P = 0.005) in patients with an adrenomedullin level > 0.053 than in those with a level ConclusionsAdrenomedullin levels are upregulated in DM patients with RP-ILD and are associated with ILD severity and poor prognosis. Adrenomedullin may be a potential prognostic biomarker in DM patients with ILD, although need further investigation.
URI http://hdl.handle.net/20.500.11897/648050
ISSN 1664-3224
DOI 10.3389/fimmu.2022.885142
Indexed SCI(E)
Appears in Collections: 中日友好医院

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