Successful classification of macrophage-mannose receptor CD206 in severity of anti-MDA5 antibody positive dermatomyositis associated ILD

Abstract

Objectives Macrophage-mannose receptor, CD206, is a marker of alternatively activated macrophages. Activated macrophages play key roles in DM. Interstitial lung disease (ILD) is a leading cause of mortality in patients with DM/clinically amyopathic DM (CADM). In particular, patients with the anti-melanoma differential gene 5 antibody (MDA5) frequently develop fatal rapid progressive ILD. This study aimed to evaluate the clinical implications of alternatively activated macrophages in patients with CADM/DM-ILD with anti-MDA5 antibody (MDA5-CADM/DM-ILD). Methods We measured serum concentrations of soluble CD206 (sCD206) in 33 patients with MDA5-CADM/DM-ILD and 36 age- and sex-matched control subjects. Expression levels of CD206 in the lungs from MDA5-CADM/DM-ILD were also examined. Results Patients with MDA5-CADM/DM-ILD had higher levels of sCD206 than those in controls (P < 0.0001). Of the 33 patients, 10 MDA5-CADM/DM-ILD patients developed fatal respiratory failure. Concentrations of sCD206 in patients with fatal ILD cases were significantly higher than those in the survivors, and increased sCD206 levels were associated with a higher mortality rate (Log-rank test, P = 0.0009). Age- and gender-adjusted logistic regression analyses showed that sCD206 was an independent prognostic factor for MDA5-CADM/DM-ILD. Importantly, assessment by sCD206 together with PaO2 successfully divided into three groups by their prognosis (P < 0.005, respectively). Pathological analyses showed accumulations of CD206-positive macrophages in lungs from the fatal case rather than those in the non-fatal cases. Conclusions Levels of serum sCD206 are increased in MDA5-CADM/DM-ILD and associated with poor prognosis. sCD206 is a potential biomarker to predict the severity of MDA5-CADM/DM-ILD.

Community-Acquired Pneumonia and Hospital-Acquired Pneumonia in Adult Patients with Idiopathic Inflammatory Myopathy: Outcome and Antibiotic Therapy

“…ILD and rapid progression of ILD (RP-ILD) were evaluated by experienced radiologists using high-resolution computed tomography (HRCT). A subset of patients with RP-ILD was defined as those presenting with progressive dyspnea and progressive hypoxemia or a worsening of interstitial change on the chest radiograph within 1 month after the initial visit or onset of respiratory symptoms [17][18][19][20][21]. Patients included can be subcategorized as CAP and HAP [22,23].…”

Macrophage Mannose Receptor CD206 Predicts Prognosis in Community-acquired Pneumonia

“…To date, in line with our study on CD206, the utility of macrophage-related markers such as scavenger receptor CD163 and the immunomodulatory molecule IDO have been vigorously investigated in clinical settings with a variety of diseases, as a surrogate marker to estimate disease severity and/or prognosis 4,5,26–30 . In addition, elevated levels of sCD206 in patients with interstitial lung disease 31 , critical illness 32 , and pneumococcal bacteremia 33 were also reported. Therefore, elevated levels of these molecules including sCD206 are not disease-specific but might also comprehensively represent a whole-body immune response.…”

AST/ALT ratio as a predictor of mortality and future exacerbations of PM/DM-ILD——a retrospective cohort study with 522 cases

“…including Krebs von den Lungen-6 antigen [40], CD4 + CXCR4 + T cells [41], microRNA-200c [42], soluble CD206 [43], progranulin [44], succeeded to predict short-term or long-term prognosis in patients with PM/DM-ILD. The fact that high DDR acted as an independent predictor of 1-year mortality in our study suggest that this easy-to-obtain biomarker may be used to identify high-risk patients that require more intensive treatment.…”