The Clinical Siginificance Of Biomarkers In Idiopathic Inflammatory Myopathy With Interstitial Lung Disease

Objective:Interstitial lung disease(ILD)is a prevalent and often devastating manifestation of idiopathic inflammatory myopathy(IIM),The main objective of this article is to investigate the clinical significance of multiple biomarkers in IIM-ILD.Method:122 patients with IIM hospitalised in Department of Rheumatology and Immunology,Xiangya Hospital,Central South University,from January 2020 to December 2021 were enrolled,clinical symptoms,myocardial enzyme,complement,C-reactive protein(CRP),erythrocyte sedimentation(ESR),tumor makers,krebs von den lungen-6(KL-6),serum ferritin,myositis autoantibodies,lung HRCT,lung function test,and other clinical datas were collected.Serum samples from 40 normal controls were collected.The level of B cell stimulating factor of the TNF family(BAFF),CC chemokine ligand 18(CCL-18),surfactant protein D(SP-D),interleukin-18(IL-18)and were detected.The clinical data,BAFF,CCL-18,SP-D,IL-18,KL-6,serum ferritin were compared between ILD patients and non-ILD patients,and between patients with different autoantibodies,the correlation between the different biomarkers,and biomarkers and lung HRCT score and lung function test were analysed.Results:(1)BAFF,SP-D,IL-18,KL-6 and serum ferritin were significantly increased in patients with IIM-ILD(P<0.05).(2)SP-D,IL-18 and KL-6were independent risk factors of ILD,and their combination had the strongest predictive value of IIM-ILD(AUC=0.888,P=0.000).(3)The diagnostic specificity of BAFF for IM-ILD was high(97.2%).(4)Serum ferritin in anti-MDA5 antibody positive IIM-ILD patients was higher than that ASA positive and double negative IIM-ILD patients.(5)CCL18 and SP-D in ASA positive IIM-ILD patients were significantly higher than those in anti-MDA5 antibody positive and double negative patients.(6)IL-18 in anti-MDA5 antibody and ASA positive IIM-ILD patients was significantly higher than that in double negative patients.(7)SP-D,KL-6were positive correlated with lung HRCT score(P<0.05).(8)KL-6 and serum ferritin were negative correlated with lung function test(P<0.05).Conclusion:Multiple biomarkers such as serum BAFF,SP-D,IL-18,KL-6 and ferritin are helpful for the diagnosis and severity assessment of IIM-ILD.CCL18 may be involved in the pathogenesis of ASS-ILD.