TY - JOUR
T1 - Evaluation of usefulness in surfactant protein D as a predictor of mortality in myositis-associated interstitial lung disease
AU - A Multicenter Retrospective Cohort of Japanese Patients with Myositis-associated ILD (JAMI) investigators
AU - Kaieda, Shinjiro
AU - Gono, Takahisa
AU - Masui, Kenichi
AU - Nishina, Naoshi
AU - Sato, Shinji
AU - Kuwana, Masataka
AU - Kawaguchi, Yasushi
AU - Kawakami, Atsushi
AU - Ikeda, Kei
AU - Tamura, Maasa
AU - Kirino, Yohei
AU - Yamaguchi, Yukie
AU - Tanino, Yoshinori
AU - Nunokawa, Takahiro
AU - Kaneko, Yuko
AU - Asakawa, Katsuaki
AU - Ukichi, Taro
AU - Naniwa, Taio
AU - Okano, Yutaka
AU - Taniguchi, Yoshinori
AU - Kikuchi, Jun
AU - Kubo, Makoto
AU - Watanabe, Masaki
AU - Harada, Tatsuhiko
AU - Kazuyori, Taisuke
AU - Kameda, Hideto
AU - Kaburaki, Makoto
AU - Matsuzawa, Yasuo
AU - Yoshida, Shunji
AU - Yoshioka, Yasuko
AU - Hirai, Takuya
AU - Wada, Yoko
AU - Ishii, Koji
AU - Fujiwara, Sakuhei
AU - Saraya, Takeshi
AU - Morimoto, Kozo
AU - Hara, Tetsu
AU - Suzuki, Hiroki
AU - Shibuya, Hideki
AU - Muro, Yoshinao
AU - Aki, Ryoichi
AU - Shibayama, Takuo
AU - Ohshima, Shiro
AU - Yasuda, Yuko
AU - Terada, Masaki
AU - Kawahara, Yoshie
N1 - Funding Information:
This work was supported by a research grant for intractable diseases from the Japanese Ministry of Health, Labour and Welfare. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
PY - 2020/6
Y1 - 2020/6
N2 - Objective Surfactant protein D (SP-D) is considered a serum biomarker of various forms of interstitial lung disease (ILD). In this study, we examined the utility of SP-D as a predictive biomarker for mortality in patients with ILD associated with polymyositis/dermatomyositis (PM/DM) using large-scale multicentre cohort data. Methods We enrolled 381 patients with incident PM/DM-associated ILD in a multicentre retrospective cohort based on the availability of serum SP-D at the baseline. Demographic and clinical characteristics as well as the presence of autoantibodies to melanoma differentiation-associated gene 5 (MDA5) and aminoacyl tRNA synthetase were measured at the time of diagnosis, and follow-up survival data were collected prospectively. Results Seventy-eight patients died during the median observation period of 18 months, and the majority of patients died of ILD. The SP-D levels at baseline were significantly lower (P = 0.02) in a non-survivor subset than in a survivor subset among the entire enrolled patients. However, the SP-D levels were higher in the non-survivor subset than in the survivor subset based on the stratification by anti-MDA5-positive, anti-ARS-positive and, double-negativity, although there was an only statistically significant difference (P = 0.01) in the double-negative group. Surprisingly, the SP-D levels were within the upper limit of normal, 110 ng/mL, in 54 (87%) of 62 anti-MDA5-positive patients who died. In the double-negative group, the mortality rates were significantly higher (P = 0.002) in a subset with SP-D ≥127.6 ng/mL, the cut-off value for mortality calculated by the receiver operating characteristic curve, than the other subset. All of patients with SP-D <127.6 ng/mL survived. Conclusion Serum SP-D levels behave differently among patients with stratified by anti-MDA5 antibody, anti-ARS antibody and both negativity in PM/DM-associated ILD. Its use in clinical practice should be applied with caution on the basis of the presence or absence of anti-MDA5 antibody or anti-ARS antibody.
AB - Objective Surfactant protein D (SP-D) is considered a serum biomarker of various forms of interstitial lung disease (ILD). In this study, we examined the utility of SP-D as a predictive biomarker for mortality in patients with ILD associated with polymyositis/dermatomyositis (PM/DM) using large-scale multicentre cohort data. Methods We enrolled 381 patients with incident PM/DM-associated ILD in a multicentre retrospective cohort based on the availability of serum SP-D at the baseline. Demographic and clinical characteristics as well as the presence of autoantibodies to melanoma differentiation-associated gene 5 (MDA5) and aminoacyl tRNA synthetase were measured at the time of diagnosis, and follow-up survival data were collected prospectively. Results Seventy-eight patients died during the median observation period of 18 months, and the majority of patients died of ILD. The SP-D levels at baseline were significantly lower (P = 0.02) in a non-survivor subset than in a survivor subset among the entire enrolled patients. However, the SP-D levels were higher in the non-survivor subset than in the survivor subset based on the stratification by anti-MDA5-positive, anti-ARS-positive and, double-negativity, although there was an only statistically significant difference (P = 0.01) in the double-negative group. Surprisingly, the SP-D levels were within the upper limit of normal, 110 ng/mL, in 54 (87%) of 62 anti-MDA5-positive patients who died. In the double-negative group, the mortality rates were significantly higher (P = 0.002) in a subset with SP-D ≥127.6 ng/mL, the cut-off value for mortality calculated by the receiver operating characteristic curve, than the other subset. All of patients with SP-D <127.6 ng/mL survived. Conclusion Serum SP-D levels behave differently among patients with stratified by anti-MDA5 antibody, anti-ARS antibody and both negativity in PM/DM-associated ILD. Its use in clinical practice should be applied with caution on the basis of the presence or absence of anti-MDA5 antibody or anti-ARS antibody.
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U2 - 10.1371/journal.pone.0234523
DO - 10.1371/journal.pone.0234523
M3 - Article
C2 - 32525903
AN - SCOPUS:85086356296
VL - 15
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 6 June
M1 - e0234523
ER -