Expression of Inflammatory Markers in the Muscles of Patients with Idiopathic Inflammatory Myopathy According to the Presence of Interstitial Lung Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Histopathologic and Immunohistochemistry Analysis
2.3. Statistical Analysis
3. Results
3.1. Comparison of Clinical Features According to the Presence of ILD
3.2. Immunohistochemistry Staining Features According to the Presence of ILD
3.3. Factors Associated with ILD in Idiopathic Inflammatory Myositis Patients
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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ILD (+) (n = 49) | ILD (−) (n = 80) | p | |
---|---|---|---|
Diagnosis of IIMs | 0.60 | ||
Dermatomyositis | 27 (55%) | 39 (49%) | |
Polymyositis | 22 (45%) | 41 (51%) | |
ILD pattern | |||
Nonspecific interstitial pneumonia | 26 (53%) | ||
Organizing pneumonia | 18 (37%) | ||
Usual interstitial pneumonia | 3 (6%) | ||
Unclassified interstitial lung abnormality | 2 (4%) | ||
Clinical characteristics | |||
Age at diagnosis, years | 54 (42–60) | 53 (41–64) | 0.82 |
Male sex | 18 (37%) | 26 (33%) | 0.76 |
Heliotrope rash | 10 (20%) | 23 (29%) | 0.40 |
Gottron’s sign/papules | 14 (29%) | 21 (26%) | 0.93 |
V or Shawl sign | 7 (14%) | 22 (28%) | 0.13 |
Dysphagia | 12 (25%) | 27 (34%) | 0.36 |
Proximal symmetric weakness | 43 (88%) | 76 (95%) | 0.18 |
Myopathy on electromyography | 35 (80%) | 69 (91%) | 0.14 |
Laboratory finding | |||
Muscle enzyme | |||
Creatine kinase, U/L | 1505 (502–53,290) | 2755 (412–7404) | 0.48 |
Myoglobin, ng/mL | 559 (196–1714) | 752 (223–2219) | 0.63 |
Lactate dehydrogenase, U/L | 627 (416–996) | 587 (368–1197) | 0.88 |
Autoantibodies | |||
Anti-Jo (n = 108) * | 13 (27%) | 2 (3%) | 0.001 |
Anti-Ro (n = 101) * | 21 (47%) | 11 (20%) | 0.007 |
ESR, mm/h | 51 (36–67) | 41 (25–59) | 0.15 |
CRP, mg/dL | 1.2 (0.5–3.6) | 0.4 (0.1–1.8) | 0.003 |
Histopathologic findings | |||
Fiber necrosis | 23 (47%) | 45 (56%) | 0.40 |
Fiber size variation atrophic fibers | 46 (94%) | 76 (95%) | 0.99 |
Internal nuclei | 26 (53%) | 45 (56%) | 0.86 |
Moth-eaten fibers | 1 (2%) | 5 (6%) | 0.41 |
Fiber splitting | 8 (16%) | 21 (26%) | 0.27 |
Perifascicular atrophy | 16 (20%) | 7 (14%) | 0.56 |
Endomyseal lymphocyte | 53 (66%) | 33 (67%) | 1.00 |
Perimyseal lymphocyte | 52 (65%) | 39 (80%) | 0.12 |
ILD (+) (n = 49) | ILD (−) (n = 80) | p | |
---|---|---|---|
Inflammatory cell expression | |||
CD3 | 25 (51%) | 27 (34%) | 0.052 |
CD4 | 23 (47%) | 23 (29%) | 0.036 |
CD8 | 15 (31%) | 14 (18%) | 0.08 |
CD20 | 12 (25%) | 10 (13%) | 0.08 |
CD68 | 25 (51%) | 30 (38%) | 0.13 |
CD163 | 22 (45%) | 32 (40%) | 0.72 |
MX1 expression | |||
Immune cell | 14 (29%) | 10 (13%) | 0.023 |
Myofiber | 10 (20%) | 20 (25%) | 0.55 |
Capillary | 34 (69%) | 43 (54%) | 0.08 |
Expression of MHC molecules on myofibers | |||
MHC class 1 | 33 (67%) | 33 (41%) | 0.004 |
HLA-DR | 18 (37%) | 9 (11%) | 0.001 |
OR | 95% CI | p | |
---|---|---|---|
Clinical characteristics | |||
Age at diagnosis (per 1 year increase) | 1.01 | 0.98–1.03 | 0.65 |
Male sex | 1.21 | 0.57–2.54 | 0.62 |
Heliotrope rash | 0.64 | 0.26–1.45 | 0.29 |
Gottron’s sign/papules | 1.12 | 0.50–2.48 | 0.77 |
V or shawl sign | 0.44 | 0.16–1.08 | 0.09 |
Dysphagia | 0.64 | 0.28–1.39 | 0.27 |
Proximal symmetric weakness | 0.38 | 0.09–1.39 | 0.15 |
Myopathy on electromyography | 0.39 | 0.13–1.14 | 0.09 |
Myalgia | 1.56 | 0.75–3.22 | 0.23 |
Laboratory finding | |||
Creatine kinase (per 1 U/L increase) | 1.00 | 1.00–1.00 | 0.29 |
ESR (per 1 mm/h increase) | 1.01 | 1.00–1.02 | 0.21 |
CRP (per 1 mg/dL increase) | 0.99 | 0.89–1.09 | 0.86 |
Anti-Ro titer (per 1 U/mL increase) | 1.01 | 1.00–1.01 | 0.016 |
Anti-Jo-1 titer (per 1 U/mL increase) | 1.03 | 1.00–1.06 | 0.023 |
Histopathologic finding a | |||
Fiber necrosis | 1.09 | 0.66–1.80 | 0.73 |
Fiber size variation atrophic fibers | 0.68 | 0.40–1.15 | 0.16 |
Internal nuclei | 1.25 | 0.78–1.99 | 0.35 |
Moth-eaten fibers | 0.31 | 0.02–2.02 | 0.30 |
Fiber splitting | 0.55 | 0.21–1.32 | 0.19 |
Perifascicular atrophy | 0.67 | 0.24–1.71 | 0.41 |
Endomyseal lymphocyte | 1.10 | 0.74–1.67 | 0.63 |
Perimyseal lymphocyte | 1.20 | 0.92–1.58 | 0.19 |
IHC staining a | |||
Expression of - inflammatory cells | |||
CD3 | 1.67 | 1.03–2.77 | 0.040 |
CD4 | 1.80 | 1.22–2.72 | 0.004 |
CD8 | 1.43 | 0.92–2.25 | 0.11 |
CD20 | 1.54 | 1.03–2.34 | 0.039 |
CD68 | 1.58 | 0.93–2.72 | 0.09 |
CD163 | 1.42 | 0.83–2.44 | 0.20 |
MX1 expression | |||
Immune cell | 1.89 | 1.16–3.16 | 0.012 |
Myofiber | 0.84 | 0.56–1.22 | 0.37 |
Capillary | 1.33 | 0.91–1.97 | 0.14 |
Expression of MHC molecules on myofibers | |||
MHC class 1 | 1.72 | 1.11–2.76 | 0.019 |
HLA-DR | 2.18 | 1.40–3.53 | <0.001 |
Model 1 * | Model 2 † | Model 3 ‡ | |||||||
---|---|---|---|---|---|---|---|---|---|
Factors | OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p |
V or Shawl sign | 0.31 | 0.08–1.10 | 0.08 | ||||||
Myopathy on electromyography | 0.18 | 0.02–0.95 | 0.06 | ||||||
Anti-Jo-1 titer (per 1 U/mL increase) | 1.02 | 1.00–1.05 | 0.06 | 1.02 | 1.00–1.05 | 0.07 | |||
CD4 expression a | 1.76 | 0.96–3.31 | 0.07 | ||||||
CD8 expression a | 0.56 | 0.27–1.13 | 0.11 | 0.53 | 0.24–1.10 | 0.10 | |||
MX1 expression on immune cells a | 1.51 | 0.87–2.67 | 0.15 | ||||||
HLA-DR expression on myofibers a | 1.97 | 1.16–3.49 | 0.015 | 1.62 | 0.96–2.85 | 0.08 | 2.39 | 1.24–4.90 | 0.012 |
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Lee, J.S.; Ghang, B.; Choi, W.; Hong, S.; Kim, Y.-G.; Lee, C.-K.; Nam, S.J.; Yoo, B. Expression of Inflammatory Markers in the Muscles of Patients with Idiopathic Inflammatory Myopathy According to the Presence of Interstitial Lung Disease. J. Clin. Med. 2022, 11, 3021. https://doi.org/10.3390/jcm11113021
Lee JS, Ghang B, Choi W, Hong S, Kim Y-G, Lee C-K, Nam SJ, Yoo B. Expression of Inflammatory Markers in the Muscles of Patients with Idiopathic Inflammatory Myopathy According to the Presence of Interstitial Lung Disease. Journal of Clinical Medicine. 2022; 11(11):3021. https://doi.org/10.3390/jcm11113021
Chicago/Turabian StyleLee, Jung Sun, Byeongzu Ghang, Wonho Choi, Seokchan Hong, Yong-Gil Kim, Chang-Keun Lee, Soo Jeong Nam, and Bin Yoo. 2022. "Expression of Inflammatory Markers in the Muscles of Patients with Idiopathic Inflammatory Myopathy According to the Presence of Interstitial Lung Disease" Journal of Clinical Medicine 11, no. 11: 3021. https://doi.org/10.3390/jcm11113021