title: Cytokine profiles in polymyositis and dermatomyositis complicated by rapidly progressive or chronic interstitial lung disease.
abstract: OBJECTIVE
  PM and DM are often complicated by interstitial lung disease (ILD). In this study we aimed to evaluate various serum cytokines in patients with PM/DM with ILD so as to clarify the differences in pathophysiology between anti-melanoma differentiation-associated gene 5 antibody-associated ILD (anti-MDA5-ILD) and anti-aminoacyl tRNA synthetase antibody-associated ILD (anti-ARS-ILD).
  
  
  METHODS
  We evaluated the serum cytokine profiles of 38 patients with PM/DM and compared the cytokine profiles of the non-ILD and ILD subsets as well as the anti-MDA5-ILD and anti-ARS-ILD subsets.
  
  
  RESULTS
  The myositis intention-to-treat activity index score, which indicates whole disease activity, significantly correlated with serum IL-6, IL-8, TNF-α and IP-10. These cytokine levels were significantly higher in the ILD subset than the non-ILD subset and were lower in the ILD subset following treatment. By multivariate analysis, TNF-α was the most significant cytokine [P = 0.0006, odds ratio (OR) 1.4, CI 1.1, 2.2] associated with PM/DM with ILD. IL-8 levels were significantly higher in anti-MDA5-ILD than in anti-ARS-ILD, although IL-6, TNF-α and IP-10 levels were high in both subsets. IL-8 was the most significant cytokine (P = 0.0006, OR 1.5, CI 1.1, 3.0) associated with anti-MDA5-ILD by multivariate analysis. Moreover, the ratio of IL-4 to IFN-γ was lower in anti-MDA5-ILD than in anti-ARS-ILD.
  
  
  CONCLUSIONS
  IL-6, IL-8, TNF-α and IP-10 are associated with global disease activity in PM/DM. These cytokine levels were high, especially in the ILD subset. Serum IL-8 levels and the balance between IL-4 and IFN-γ may contribute to the differences in pathophysiology between anti-ARS-ILD and anti-MDA5-ILD.
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Takahisa
authors: T
authors: Gono
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Hirotaka
authors: H
authors: Kaneko
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. y-kawa@ior.twmu.ac.jp.
authors: Yasushi
authors: Y
authors: Kawaguchi
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Masanori
authors: M
authors: Hanaoka
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Sayuri
authors: S
authors: Kataoka
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Masataka
authors: M
authors: Kuwana
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Kae
authors: K
authors: Takagi
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Hisae
authors: H
authors: Ichida
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Yasuhiro
authors: Y
authors: Katsumata
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Yuko
authors: Y
authors: Ota
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Hidenaga
authors: H
authors: Kawasumi
authors: Institute of Rheumatology, Tokyo Women's Medical University and Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors: Hisashi
authors: H
authors: Yamanaka
mesh_terms: D000328:Adult; D002908:Chronic Disease; D016207:Cytokines / Q000097:blood*; D003882:Dermatomyositis / Q000150:complications / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D017563:Lung Diseases, Interstitial / Q000209:etiology / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D017285:Polymyositis / Q000150:complications / Q000276:immunology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D016207:Cytokines; C508600:IL6 protein, human; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha
keywords: IL-6; IL-8; TNF-α; dermatomyositis; interstitial lung disease; polymyositis