Institute for Experimental Medical Research and KG Jebsen Center for Cardiac Research, Oslo University Hospital and University of Oslo, Oslo, Norway.
Bjørknes University College, Oslo, Norway.
Rheumatology (Oxford). 2020 Aug 1;59(8):1862-1870. doi: 10.1093/rheumatology/kez531.
To examine associations between cytokines and pulmonary involvement in patients with medium- to long-term JDM.
In a cross-sectional study, 58 patients examined median (range) 16.8 (6.6-27.0) years after symptom onset were stratified in inactive (JDM-inactive) and active (JDM-active) disease (updated PRINTO criteria); 56 age/sex matched controls were included. Twenty-nine cytokines (in serum) were analysed (Luminex technology/ELISA). Pulmonary function test included forced vital capacity, total lung capacity (TLC) and diffusing capacity for carbon monoxide reported as % of predicted and low forced vital capacity/TLC/diffusing capacity for carbon monoxide. In patients, the presence of clinical pulmonary damage was assessed and high resolution computed tomography scans were scored for interstitial lung disease, chest wall calcinosis and airways disease.
Median age of patients was 21 (7-55) years, 59% were female and 36% inactive. In JDM-active and all patients, higher MCP-1, IP-10 and eotaxin correlated with high-resolution computed tomography findings (rs 0.34-0.61; P < 0.05). MCP-1 and eotaxin correlated with pulmonary damage in JDM-active and all patients (rs 0.41-0.49; P < 0.01). Higher TGF-β1 and PDGF (growth factors) were associated with lower lung volumes (forced vital capacity/TLC measures) in all patients; PDGF in JDM-active and TGF-β1 in JDM-inactive patients. IP-10 correlated with TLC% in JDM-active patients. No associations between cytokines and pulmonary function test were found in controls.
In JDM, we found a novel association (not previously described in myositis) between eotaxin and pulmonary involvement; we have previously shown an association between eotaxin and cardiac dysfunction. The associations between IP-10/growth factors/MCP-1 and pulmonary involvement are novel in JDM and were mostly seen in JDM-active patients.
研究中至长程皮肌炎（JDM）患者细胞因子与肺部受累之间的相关性。
采用病例对照研究，纳入 58 例 JDM 患者，中位（范围）发病后 16.8（6.6-27.0）年，根据更新的 PRINTO 标准分为疾病活动组（JDM-活动）和疾病非活动组（JDM-非活动）；纳入 56 例年龄和性别匹配的对照。采用 Luminex 技术/ELISA 检测血清中 29 种细胞因子。肺功能检查包括用力肺活量（FVC）、总肺量（TLC）和一氧化碳弥散量（DLCO），并以预计值的百分比表示。评估患者的临床肺部损伤情况，并对高分辨率 CT 扫描的间质性肺疾病、胸壁钙化和气道疾病进行评分。
患者中位年龄为 21（7-55）岁，59%为女性，36%为疾病非活动。在 JDM-活动和所有患者中，MCP-1、IP-10 和 eotaxin 水平与高分辨率 CT 结果相关（rs 0.34-0.61；P<0.05）。MCP-1 和 eotaxin 与 JDM-活动和所有患者的肺部损伤相关（rs 0.41-0.49；P<0.01）。所有患者中，TGF-β1 和 PDGF（生长因子）水平较高与 FVC/TLC 测量值较低相关；在 JDM-活动和 JDM-非活动患者中，PDGF 与 TGF-β1 相关。IP-10 与 JDM-活动患者的 TLC%相关。在对照组中未发现细胞因子与肺功能检查之间的相关性。
在 JDM 中，我们发现 eotaxin 与肺部受累之间存在新的相关性（在肌炎中尚未有报道）；我们之前已证明 eotaxin 与心脏功能障碍相关。IP-10/生长因子/MCP-1 与肺部受累的相关性在 JDM 中是新的，且主要见于 JDM-活动患者。
