Cytokine profiles of amyopathic dermatomyositis with interstitial lung diseases treated with mycophenolate

Abstract

A 59‐year‐old Japanese man diagnosed with interstitial lung disease associated with amyopathic dermatomyositis with anti‐melanoma differentiation‐associated gene 5 (MDA‐5) antibodies was treated with intravenous methyl prednisolone (PSL) 1000 mg, oral PSL 1 mg/kg, and oral cyclosporin 200 mg daily. His respiratory condition worsened after treatment with two times of intravenous cyclophosphamide and another steroid pulse therapy as well as PSL and cyclosporin. Addition of mycophenolate mofetil (MMF), 1.5 g daily improved PaO2/FiO2 (PF) ratio of the patient from 294 to 360 at 4 weeks and 416 at 15 weeks after addition of MMF. We measured cytokine concentration in preserved serum taken at 11 and 7 weeks before addition of MMF and at 4, 11, and 15 weeks after MMF administration. Of the 28 cytokines evaluated, the concentrations of fibroblast growth factors‐2 (FGF‐2), chemokine (C‐X3‐C motif) ligand 1 (CX3CL1), interleukin (IL)‐1ra, IL‐17A, inducible protein 10 (IP‐10), and monocyte chemotactic protein‐1 (MCP‐1) decreased after addition of MMF. These results suggest that MMF may be beneficial to patients with interstitial lung disease by modification of the cytokine/growth factor protein expression.

Immunochemotherapeutic increase of peripheral absolute monocyte count predicts interstitial pneumonia in lymphoma patients

“…Also, Osterholzer et al suggested that injury toward alveolar epithelial cell could induce inflammatory response resulting in the enrichment of Ly‐6C high monocytes as well . Meanwhile, Hayashi et al identified the decrease of several cytokines after IP‐treatment, including CD87 (augment monocyte adhesion) and MCP‐1 (mediate monocyte chemotactic) . All these evidences emphasized the impact of monocytes on the onset and progress of IP.…”

Understanding and managing anti-MDA 5 dermatomyositis, including potential COVID-19 mimicry

“…Patients with ILD and anti-MDA5 antibodies are at a higher risk of pneumocystis carinii pneumonia and prophylaxis should considered for these patients [61]. When the use of calcineurin inhibitors is not feasible, Mycophenolate Mofetil and Rituximab have been used, albeit unsuccessfully in some case reports [87,88].…”

<p>Emerging Role of Fractalkine in the Treatment of Rheumatic Diseases</p>

“… 63 Notably, in ADM patients who have antibodies against CADM-140/MDA5 (clinically amyopathic dermatomyositis-140/melanoma differentiation-associated gene 5), serum FKN levels and the anti-CADM-1/MDA5 antibody titer not only correlated with each other but also both correlated with disease activity. 49 , 50 Takada et al also reported that the anti-CADM-140/MDA5 antibody titer can predict the course of rapidly progressing ADM-related ILD. 50 …”

“…Interstitial lung disease (ILD) is a common extraarticular complication of RA that worsens the prognosis and increases mortality in refractory cases. 46 The role of FKN in the pathogenesis of ILD is currently unknown; however, the FKN–CX3CR1 axis has been implicated in lung involvement in patients with systemic sclerosis (SSc) 47 , 48 and amyopathic dermatomyositis (ADM), 49 , 50 suggesting that this mechanism might also be involved in RA-associated ILD. In a bleomycin-induced model of pulmonary fibrosis, mice lacking C x3 cr1 had reduced levels of pulmonary fibrosis, suggesting that FKN contributes to an inflammatory state that exacerbates ILD.…”