Department of Dermatology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, 200025, Shanghai, China.
Department of Respiratory Diseases, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, 200025, Shanghai, China.
Br J Dermatol. 2018 Dec;179(6):1334-1341. doi: 10.1111/bjd.17079. Epub 2018 Oct 7.
Dermatomyositis (DM) is an autoimmune disease affecting primarily the skin, muscle and lung. Dysregulations of cytokines and chemokines are commonly found in inflammatory disorders.
To investigate the association between serum cytokines and chemokines and clinical severity, especially cutaneous lesions and interstitial lung disease (ILD) in patients with DM and clinically amyopathic DM (CADM).
Clinical features, laboratory findings and serum of 40 patients with DM or CADM were collected and analysed. Serum cytokines and chemokines were measured by enzyme-linked immunosorbent assay or cytometric bead array. A multiple unpaired t-test was performed to compare cytokines and chemokines in patients with DM and healthy controls. Correlations of serum cytokines and chemokines with disease severity were evaluated by Spearman's rank correlation test.
Serum interferon (IFN)-β [r = 0·37, 95% confidence interval (CI) 0·078-0·62; P = 0·019] and CXCL10 (r = 0·32, 95% CI to -0·004 to 0·57; P = 0·045) were significantly correlated with the Cutaneous Dermatomyositis Disease Area and Severity Index activity score in the subset of patients with DM or CADM. Serum levels of interleukin (IL)-6, IL-10, IL-18 and IFN-β were significantly higher in the patients with acute/subacute interstitial pneumonia (A/SIP) than in the subset without A/SIP (P < 0·05). IL-6 (r = 0·54, 95% CI 0·27-0·72; P < 0·001) and IL-18 (r = 0·46, 95% CI 0·21-0·65; P = 0·003) were significantly correlated with the serum level of anti-melanoma differentiation-associated protein 5 antibody.
Serum levels of IFN-β and CXCL10 may be useful biomarkers for assessing cutaneous disease activity in patients with DM and CADM. In addition, serum IL-6, IL-10, IL-18 and IFN-β were highly correlated with the occurrence of A/SIP. These cytokines may play a role in the pathogenesis of DM and CADM.
皮肌炎（DM）是一种主要影响皮肤、肌肉和肺部的自身免疫性疾病。细胞因子和趋化因子的失调在炎症性疾病中很常见。
探讨血清细胞因子和趋化因子与临床严重程度的关系，特别是皮肌炎患者和临床无肌病性皮肌炎（CADM）患者的皮肤损伤和间质性肺病（ILD）。
收集并分析了 40 例皮肌炎或 CADM 患者的临床特征、实验室检查结果和血清。通过酶联免疫吸附试验或流式细胞术检测血清细胞因子和趋化因子。采用多组非配对 t 检验比较皮肌炎患者和健康对照组的细胞因子和趋化因子。采用 Spearman 秩相关检验评估血清细胞因子和趋化因子与疾病严重程度的相关性。
在皮肌炎或 CADM 患者亚组中，血清干扰素（IFN）-β [r = 0.37，95%置信区间（CI）0.078-0.62；P = 0.019] 和 CXCL10 [r = 0.32，95%CI-0.004 至 0.57；P = 0.045] 与皮肤肌炎疾病面积和严重程度指数活动评分显著相关。急性/亚急性间质性肺炎（A/SIP）患者的血清白细胞介素（IL）-6、IL-10、IL-18 和 IFN-β 水平明显高于无 A/SIP 患者亚组（P<0.05）。IL-6 [r = 0.54，95%CI 0.27-0.72；P<0.001] 和 IL-18 [r = 0.46，95%CI 0.21-0.65；P = 0.003] 与抗黑色素瘤分化相关蛋白 5 抗体的血清水平显著相关。
血清 IFN-β 和 CXCL10 水平可能是评估皮肌炎和 CADM 患者皮肤疾病活动的有用生物标志物。此外，血清 IL-6、IL-10、IL-18 和 IFN-β 与 A/SIP 的发生高度相关。这些细胞因子可能在皮肌炎和 CADM 的发病机制中发挥作用。
