MDA-5抗体可作为皮肌炎诊断及预后评估的生物标记物

作者：Li L， et al.

翻译：北医三院聂丹

摘要：MDA-5抗体是特发性肌炎患者诊断及预测预后的重要生物标记物。由于关于MDA-5抗体检测结果存在争议，本研究致力于评估MDA-5抗体与皮肌炎/多发性肌炎之间的潜在联系，以及MDA-5抗体对皮肌炎/多发性肌炎的诊断和预后评估价值。为此，我们对2016年10月15日之前的文献进行了回顾。根据入组条件，8项共包含268个皮肌炎患者及216个健康对照的研究和9项共包含628多发性肌炎及221个健康对照的研究被选出，这些研究的结果表明,MDA-5抗体阳性与皮肌炎,尤其是无肌病皮肌炎相关，而与肌炎无关。此外，应用免疫沉淀法检测时，对于无肌病皮肌炎和健康对照者相比汇总的灵敏度、特异性和曲线下面积值分别为0.62、1和0.9381。MDA-5抗体还与皮肌炎患者死亡率增加有关。这些发现表明，MDA-5抗体与皮肌炎相关，且可以作为无肌病皮肌炎临床诊断的生物标记物。对于皮肌炎总体死亡率来说，MDA-5阳性与不良预后相关。

附原文：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.

引自：Li L, Wang Q, Yang F, Wu C, Chen S, Wen X, Liu C, Li Y. Anti-MDA5 antibody as a potential diagnostic and prognostic biomarker in patients with dermatomyositis.Oncotarget，2017.2（24）