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抗黑色素瘤分化相关基因 5 抗体与皮肌炎患者的人口统计学、临床特征和实验室结果的关联:系统荟萃分析。

Associations between anti-melanoma differentiation-associated gene 5 antibody and demographics, clinical characteristics and laboratory results of patients with dermatomyositis: A systematic meta-analysis.

机构信息

Department of Rheumatology, Huai'an First People's Hospital, Nanjing Medical University, Jiangsu, China.

出版信息

J Dermatol. 2018 Jan;45(1):46-52. doi: 10.1111/1346-8138.14092. Epub 2017 Oct 6.

Abstract

Anti-melanoma differentiation-associated gene 5 (MDA5) antibody is a specific biomarker in patients with dermatomyositis (DM). Results from several studies that examined the relationship between anti-MDA5 antibody and the demographics, clinical characteristics and laboratory results of DM patients have been conflicting. The purpose of this study was to identify the relationship, if any, of anti-MDA5 antibody with demographics, clinical characteristics and laboratory results of DM patients. PubMed, Web of Science, Embase and the Cochrane Library databases were searched for studies without language restrictions conducted before 16 March 2017. Stata version 12.0 software was used to calculate pooled odds ratios or weighted mean differences and corresponding 95% confidence intervals to determine the relationship between anti-MDA5 antibody and patient characteristics. Twenty studies comprising 1500 cases were included in this meta-analysis. Anti-MDA5 antibody was strongly associated with clinically amyopathic DM (CADM) and rapidly progressive interstitial lung disease (RPILD). Anti-MDA5 antibody also increased the risk of developing eight characteristics comprising Gottron's sign or papules, mechanic's hand, V rash, skin ulcers, panniculitis, alopecia, arthritis/arthralgia and pneumomediastinum, but reduced the risk of muscle weakness, classic DM (CDM) and elevated creatine kinase (CK). Our meta-analysis indicated that anti-MDA5 antibody is related to muscle weakness, Gottron's sign or papules, mechanic's hand, V rash, skin ulcers, panniculitis, alopecia, arthritis/arthralgia, pneumomediastinum, RPILD, CDM, CADM and elevated CK in patients with DM.

摘要

抗黑色素瘤分化相关基因 5(MDA5)抗体是皮肌炎(DM)患者的特异性生物标志物。多项研究检查了抗 MDA5 抗体与 DM 患者的人口统计学、临床特征和实验室结果之间的关系,结果相互矛盾。本研究旨在确定抗 MDA5 抗体与 DM 患者的人口统计学、临床特征和实验室结果之间是否存在任何关系。在 2017 年 3 月 16 日之前,我们没有语言限制地在 PubMed、Web of Science、Embase 和 Cochrane Library 数据库中搜索了研究。使用 Stata 版本 12.0 软件计算汇总优势比或加权均数差值及相应的 95%置信区间,以确定抗 MDA5 抗体与患者特征之间的关系。这项荟萃分析纳入了 20 项研究,共 1500 例病例。抗 MDA5 抗体与临床无肌病性皮肌炎(CADM)和快速进展性间质性肺病(RPILD)强烈相关。抗 MDA5 抗体还增加了出现包括 Gottron 征或丘疹、技工手、V 疹、皮肤溃疡、脂膜炎、脱发、关节炎/关节痛和纵隔气肿在内的 8 种特征的风险,但降低了肌肉无力、经典皮肌炎(CDM)和肌酸激酶(CK)升高的风险。我们的荟萃分析表明,抗 MDA5 抗体与 DM 患者的肌肉无力、Gottron 征或丘疹、技工手、V 疹、皮肤溃疡、脂膜炎、脱发、关节炎/关节痛、纵隔气肿、RPILD、CDM、CADM 和 CK 升高有关。

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