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Oncotarget:抗MDA5抗体有作为DM患者急进性间质性肺病诊断中生物标志物的潜力

2017-07-25 Emma MedSci原创

为了探究抗MDA5抗体与DM-ILD或DM-RPILD之间的关系和 该抗体对DM-ILD和DM-RPILD的诊断价值,研究人员对至2017年1月14日发表的文章进行了meta分析。结果显示,在DM患者的RPILD诊断中,抗MDA5抗体具有作为非侵入性生物标志物的潜力。

ILD,即间质性肺病,也称作弥漫性实质性肺疾病或肺(间质)纤维化,是以弥漫性肺实质、肺泡炎症和间质纤维化为病理基本病变的不同种类疾病群构成的临床-病理实体的总称。所谓肺纤维化就是正常肺组织被疤痕组织取代,有如皮肤破损后结疤一样。疤痕形成使肺间质增厚,氧气就很难从肺泡转运到血液中。血液低氧导致有肺纤维化的患者感到气短和活动耐力下降,最终可导致严重的双肺纤维化(蜂窝肺),引起呼吸衰竭和肺心病。在皮肌炎合并间质性肺病(DM-ILD)和皮肌炎合并急进性间质性肺病(DM-RPILD)患者中已发现存在抗MDA5(黑素瘤分化相关蛋白5)抗体。

为了探究抗MDA5抗体与DM-ILD或DM-RPILD之间的关系和该抗体对DM-ILD和DM-RPILD的诊断价值,研究人员对至2017年1月14日发表的文章进行了meta分析。结果显示,在DM患者的RPILD诊断中,抗MDA5抗体具有作为非侵入性生物标志物的潜力。

分析中共有DM-ILD491例,无ILD的DM605例;DM-RPILD186例和无RPILD的DM790例。对于DM-ILD,抗MDA5抗体的合并敏感性值,特异性值和曲线下面积(AUC)分别为0.47(95%CI:0.37-0.57),0.96(95%CI,0.92-0.97)和0.90(95%CI:0.88-0.93),灵敏度低。此外,TSA分析显示充足证据支持抗MDA5抗体与DM-ILD和DM-RPILD相关。

原始出处:
doi: 10.18632/oncotarget.19050.

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    2018-06-08 amy0559
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    2018-02-02 wetgdt
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time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=226473, encodeId=7bf32264e3e5, content=文章很好,认真拜读, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Jul 26 09:47:09 CST 2017, time=2017-07-26, status=1, ipAttribution=)]
  5. 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href='/topic/show?id=3c746936567' target=_blank style='color:#2F92EE;'>#生物标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Thu Jul 27 14:37:00 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=226818, encodeId=1f16226818e0, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM66WRRAmeqIVSnDN88DpaJfEWzRZxg4yBbiaBmMRwcvViaA2C0sE0Ts3Lic24JSSI4YffujDtpnm0GTHpuiao9TytmNArrcYESnSXY/0, createdBy=7938104912, createdName=jacob9231, createdTime=Thu Jul 27 09:11:39 CST 2017, time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=226473, encodeId=7bf32264e3e5, content=文章很好,认真拜读, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Jul 26 09:47:09 CST 2017, time=2017-07-26, status=1, ipAttribution=)]
    2018-01-23 闆锋旦
  6. 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  7. 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  9. 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time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=226473, encodeId=7bf32264e3e5, content=文章很好,认真拜读, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Jul 26 09:47:09 CST 2017, time=2017-07-26, status=1, ipAttribution=)]
    2017-07-27 jacob9231

    学习了谢谢分享

    0

  10. 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time=2017-07-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=226473, encodeId=7bf32264e3e5, content=文章很好,认真拜读, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Jul 26 09:47:09 CST 2017, time=2017-07-26, status=1, ipAttribution=)]
    2017-07-26 1e10c84am36(暂无匿称)

    文章很好,认真拜读

    0

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糖皮质激素(glucocorticoid,GC)在生理状态下是维持机体正常物质代谢所必需的一种甾体类激素,在超生理剂量下,GC具有强大的抗炎、抗免疫作用,因而在临上其广泛应用于各种CTD及其并发症的治疗。 间质性肺病(interstitial lung disease,ILD)是CTD常见的并发症,其发病率和病死率较高,严重者可发展为呼吸衰竭导致患者死亡,因此早期

Arthritis Rheumatol:类风湿相关性间质肺病的肺功能呈进行性下降

在RA相关性ILD中肺功能的进行性下降是普遍的,并且UIP患者比NSIP患者更差。

BMJ:结缔组织疾病相关的间质性肺病的管理

BMJ:结缔组织疾病相关的间质性肺病的管理肺是全身性结缔组织病(CTD)并发症发生的常见部位,CTD累及肺时可出现几种表现。间质性肺疾病(ILD)和肺动脉高血压是最常见的肺部表现。虽然普遍认为ILD的发生晚于CTD,但是ILD通常是CTD最初的表现(以肺部为主要表现的CTD)。大部分CTD可出现ILD,包括类风湿性关节炎、硬皮病、系统性红斑狼疮、多发性肌炎或皮肌炎,舍格伦综合征以及混合性结缔组织病

Ann Rheum Dis:类风湿关节炎相关性间质性肺病的合并症及死亡率

ILD是RA的严重并发症,与匹配队列中不伴ILD的RA比较,其死亡率显著增加。

Arthritis Rheumatol:麦考酚酸莫酯治疗系统性硬化症相关性间质肺病

尽管比较来自不同试验的参与者存在固有的局限性,即使在考虑到基线疾病严重程度之后,MMF治疗与生理结局和呼吸困难改善相关。

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