Immunological Biomarkers in Dermatomyositis

Olazagasti, Jeannette M.; Niewold, Timothy B.; Reed, Ann M.

doi:10.1007/s11926-015-0543-y

Cited by 13 publications

(8 citation statements)

References 44 publications

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“…However, their relationship to disease activity is variable, especially in DM, IBM, and JDM, resulting in a great need for the development of more specific and sensitive biomarkers. Presently, we understand that innate and adaptive immunity, as well as non-immune muscle-related mechanisms, are involved in IIM pathogenesis 87,88 . Genes and proteins related to immune activation are some of the many targets for new biomarkers in the IIMs.…”

Section: Biomarkersmentioning

confidence: 99%

“…Cytokines, particularly interleukin-6 (IL-6), are dysregulated in the IIMs. Studies identified IL-6 expression in both immune and muscle cells in muscle tissue 88–92 . Serum IL-6 levels are significantly elevated in DM and JDM, and they correlate with disease activity at diagnosis, with ongoing disease changes after varying treatments, and with the presence of ILD.…”

Section: Biomarkersmentioning

confidence: 99%

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Update on outcome assessment in myositis

et al. 2018

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The adult and juvenile myositis syndromes, commonly referred to collectively as idiopathic inflammatory myopathies (IIMs), are systemic autoimmune diseases with the hallmarks of muscle weakness and inflammation. Validated, well-standardized measures to assess disease activity, known as core set measures, were developed by international networks of myositis researchers for use in clinical trials. Composite response criteria using weighted changes in the core set measures of disease activity were developed and validated for adult and juvenile patients with dermatomyositis and adult patients with polymyositis, with different thresholds for minimal, moderate and major improvement in adults and juveniles. Additional measures of muscle strength and function are being validated to improve content validity and sensitivity to change. A health-related quality of life measure, which incorporates patient input, is being developed for adult patients with IIM. Disease state criteria, including criteria for inactive disease and remission, are being used as secondary end points in clinical trials. MRI of muscle and immunological biomarkers are promising approaches to discriminate between disease activity and damage and might provide much-needed objective outcome measures. These advances in the assessment of outcomes for myositis treatment, along with collaborations between international networks, should facilitate further development of new therapies for patients with IIM.

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Section: Biomarkersmentioning

confidence: 99%

Section: Biomarkersmentioning

confidence: 99%

Update on outcome assessment in myositis

et al. 2018

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“…Therefore, there is a strong relationship between chronic inflammation and SLE. The inflammatory response is always accompanied by an increased release of many cytokines and chemokines, which are proven to intensify the immunoreaction and largely contribute to the pathogenesis of SLE (36)(37)(38)(39). In particular, white blood cells (WBCs) are involved in the secretion of the cytokines and chemokines, which in turn activate these WBCs (40,41).…”

Section: ' Discussionmentioning

confidence: 99%

Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis

Wang¹,

Wang²,

Jia³

et al. 2020

Clinics

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Systemic lupus erythematosus (SLE) is a chronic systematic autoimmune disease. Current methods of diagnosing SLE or evaluating its activity are complex and expensive. Numerous studies have suggested that neutrophil-tolymphocyte ratio (NLR) is closely correlated with the presence of SLE and its activity, suggesting that it may serve as a diagnostic and monitoring indicator for SLE. Therefore, we performed a meta-analysis to systematically assess the association between NLR and SLE. We performed a literature search until 12 April 2019 in the PubMed, Web of Science, and China National Knowledge Infrastructure databases. Cross-sectional studies comparing the NLR of SLE patients versus those of healthy controls, of active versus inactive SLE patients, and of SLE patients with versus without lupus nephritis were considered for inclusion. Mean intergroup NLR differences were estimated using standardized mean differences and their 95% confidence intervals. Study quality was assessed using the Agency for Healthcare Research and Quality instrument for cross-sectional studies. Fourteen studies with 1,781 SLE patients and 1,330 healthy controls were included in this meta-analysis. The pooled results showed that the NLR was significantly higher in SLE patients than in healthy controls, in active SLE patients than in inactive SLE patients, and in SLE patients with lupus nephritis than in those without lupus nephritis. NLR may be an indicator for monitoring disease activity and reflecting renal involvement in SLE patients. Nevertheless, more high-quality studies are warranted to further validate our findings.

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“…The identification of these markers in combination with expanded diagnostic criteria, to include probable JDM for children without rash, would improve early diagnosis and outcomes for children in the future. Further study into the use of blood-borne IL-6, IL-17, IL-23, IFN-β, BAFF, resistin, TLR3 and TLR-7 may emerge as potential biomarkers for the diagnosis of JDM [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Fashionably Late: A Case of Delayed Cutaneous Manifestations in Juvenile Dermatomyositis

Antoine¹,

Reeves²,

Rohena³

et al. 2018

J Clin Med Res

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Juvenile dermatomyositis (JDM) is a rare, but well recognized multi-systemic inflammatory myopathy in children defined by proximal muscle weakness and distinctive skin lesions, that if recognized and treated early result in decreased morbidity and mortality. The 1975 criteria established by Bohan and Peter center around the propensity for early development of heliotrope and Gottron’s lesions in combination with specific laboratory abnormalities, and are still the leading diagnostic tool. The following case demonstrates a toddler with an atypical presentation of JDM in which delayed dermatologic manifestations hindered initial diagnosis. A previously healthy 2 years and 11 months old female presented to the emergency department with a 7-month history of bilateral knee pain and progressive muscular weakness. Initial evaluation yielded a diagnosis of idiopathic rhabdomyolysis but progressive deterioration prompted additional workup. During her course of care, the patient required admission at numerous facilities for specialty procedures including swallow studies, electromyography, Nissen fundoplication with G-tube insertion, and eventual muscle biopsy, resulting in pathology clinching the diagnosis. Post-diagnosis the development of a heliotrope and malar rash ensued, 11 months after commencement of original presentation. As the Bohan and Peter criteria of 1975 can help to aid in diagnosis of JDM for textbook presentations, atypical cases such as ours suggest that revision to current diagnostic criteria needs to be established. Also, with many pediatric rheumatologists opting for less invasive methods than muscle biopsy to aid in diagnosis, in combination with the heterogeneous nature of currently tracked serous markers, the risk for delayed or missed diagnosis is amplified. As prior research has demonstrated, early diagnosis leads to better outcomes for children battling JDM. Therefore, it is vital that criteria be revised and additional research be conducted for more sensitive and specific markers to help aid in early diagnosis of JDM.

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Immunological Biomarkers in Dermatomyositis

Cited by 13 publications

References 44 publications

Update on outcome assessment in myositis

Update on outcome assessment in myositis

Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis

Fashionably Late: A Case of Delayed Cutaneous Manifestations in Juvenile Dermatomyositis

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