Anti-MDA5 antibody as a potential diagnostic and prognostic biomarker in patients with dermatomyositis
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Liubing Li1,*, Qian Wang1,*, Funing Yang1,2,*, Chanyuan Wu1, Si Chen1,3, Xiaoting Wen1, Chenxi Liu1, Yongzhe Li1
1Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
2Department of Medical Laboratory, The First Hospital of Jilin University, Changchun, China
3Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
*These authors have contributed equally to this work
Yongzhe Li, email: email@example.com
Keywords: dermatomyositis, anti-MDA5, diagnosis, prognosis, marker
Received: December 08, 2016 Accepted: February 13, 2017 Published: February 24, 2017
The presence of anti-MDA5 antibodies in serum represents an important biomarker in the diagnosis and prediction of prognosis for patients with idiopathic inflammatory myopathies (IIMs). Due to conflicting results that have been reported regarding the detection of anti-MDA5 antibodies, the goal of this study was to assess a potential association between the presence of anti-MDA5 antibodies and dermatomyositis/polymyositis (DM/PM), as well as the diagnostic and prognostic values of anti-MDA5 antibodies for DM/PM. For this, a review of literature published prior to October 15, 2016 was conducted. Eight studies with 286 PM patients and 216 healthy controls and nine studies with 628 DM patients and 221 healthy controls were selected according to specific inclusion criteria. The outcomes of these studies revealed that the presence of anti-MDA5 antibodies was associated with DM, especially CADM, and not with PM. Furthermore, the pooled sensitivity, specificity, and area under the curve (AUC) values were 0.62 (95% confidence interval (CI): 0.52–0.70), 1.00 (95% CI: 0.97–1.00), and 0.9381 for CADM patients versus healthy controls when an immunoprecipitation method was used. The presence of anti-MDA5 antibodies was also found to be significantly associated with an increased risk of death in DM (relative risk = 3.32, 95% CI: 1.65–6.67, P = 0.001). These findings suggest that anti-MDA5 antibodies correlate with DM and could be used as a biomarker in the clinical diagnosis of CADM. The presence of anti-MDA5 antibodies was also associated with poor prognosis regarding the overall survival of patients with DM.
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