Anti-MDA5 antibody as a potential diagnostic and prognostic biomarker in patients with dermatomyositis

Abstract

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.

The predictive prognostic factors for polymyositis/dermatomyositis-associated interstitial lung disease

“…Our study did not show any difference in survival prognosis between CADM and classical DM. The data suggest that serological anti-MDA5 Ab is more closely associated with acute progressive ILD than CADM as a clinical phenotype, as previous studies have shown that patients with classical DM anti-MDA5 Ab present with rapidly progressive ILD as do patients with seropositive CADM [ 22 – 24 ]. Serum ferritin level has been shown to be a biomarker for the activity of ILD in patients with PM/DM [ 25 ].…”

Transposition Flap for Cutaneous Lesion Coverage in Dermatomyositis

“…Narang et al [4] reported that cutaneous ulcerations were present in 28% of 152 patients with DM and that the ulceration had potential associations with autoantibody status. The anti-melanoma differentiation-associated gene 5 antibody is known to be associated with skin ulceration in DM [5]. Cutaneous ulcerations commonly occur over Gottron papules or in areas with the Gottron sign, and often affect the skin over the extensor joint surfaces, although they could be found anywhere [6].…”

Rapidly progressive interstitial lung disease due to anti-MDA5 antibodies without skin involvement: a case report and literature review

“…The presence of anti-MDA5 antibodies has been strongly associated with RP-ILD in DM, especially in the CADM subtype [12]. A recent meta-analysis has shown they have a good sensitivity (83%) and specificity (86%) for identifying the risk of RP-ILD in this subset of patients [13]. Thus, anti-MDA5 antibodies have been proposed as a useful surrogate marker of disease activity [14][15][16].…”