Gene Expression Profiling in Blood and Affected Muscle Tissues Reveals Differential Activation Pathways in Patients with New-onset Juvenile and Adult Dermatomyositis.
To identify shared and differential molecular pathways in blood and affected muscle between adult dermatomyositis (DM) and juvenile DM, and their association with clinical disease activity measures.



Gene expression of transcription factors and cytokines involved in differentiation and effector function of T cell subsets, regulatory T cells and follicular Th cells, were analyzed in the blood from 21 newly diagnosed adult and 26 juvenile DM subjects and in 15 muscle specimens (7 adult and 8 juvenile DM) using a custom RT2 Profiler PCR Array. Disease activity was determined and measured by established disease activity tools.



The most prominent finding was the higher blood expression of Th17-related cytokines [retinoic acid-related orphan receptor-γ, interferon regulatory factor 4, interleukin (IL)-23A, IL-6, IL-17F, and IL-21] in juvenile DM at baseline. In contrast, adult patients with DM showed increased blood levels of STAT3 and BCL6 compared with juvenile DM. In muscle, GATA3, IL-13, and STAT5B were found at higher levels in juvenile patients with DM compared with adult DM. Among 25 patients (11 adult and 14 juvenile DM) who had blood samples at baseline and at 6 months, increased expression of IL-1β, STAT3, STAT6, STAT5B, and BCL6 was associated with an improvement in global extramuscular disease activity.



We observed differences in gene expression profiling in blood and muscle between new-onset adult and juvenile DM. Cytokine expression in the blood of juvenile patients with new-onset DM was dominated by Th17-related cytokines compared with adult patients with DM. This may reflect the activation of different Th pathways between muscle and blood.
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Consuelo M
CM
López De Padilla
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Cynthia S
CS
Crowson
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Molly S
MS
Hein
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Richard S
RS
Pendegraft
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Michael A
MA
Strausbauch
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Timothy B
TB
Niewold
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Floranne C
FC
Ernste
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Erik
E
Peterson
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center.
Emily C
EC
Baechler
From the Division of Rheumatology, Department of Pediatrics, Mayo Clinic; Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; Department of Surgical Research, Mayo Clinic; Division of Rheumatology and Department of Immunology, Mayo Clinic; Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine, Rochester; Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center, Durham, North Carolina, USA. ann.reed@duke.edu.|C.M. López De Padilla, MD, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; C.S. Crowson, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.S. Hein, BS, Division of Rheumatology, Department of Pediatrics, Mayo Clinic; R.S. Pendegraft, MS, Division of Rheumatology and Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic; M.A. Strausbauch, MS, Department of Surgical Research, Mayo Clinic; T.B. Niewold, MD, Division of Rheumatology and Department of Immunology, Mayo Clinic; F.C. Ernste, MD, Division of Rheumatology, Department of Internal Medicine and Department of Pediatrics, Mayo Clinic College of Medicine; E. Peterson, MD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; E.C. Baechler, PhD, Division of Rheumatic and Autoimmune diseases, Department of Medicine, University of Minnesota; A.M. Reed, MD, Department of Pediatrics, Duke Children's Hospital, Duke University Medical Center. ann.reed@duke.edu.
Ann M
AM
Reed
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000235:genetics* / Q000378:metabolism; D003882:Dermatomyositis / Q000235:genetics* / Q000378:metabolism; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D006377:T-Lymphocytes, Helper-Inducer / Q000378:metabolism*; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism*
D016207:Cytokines
CD4 T HELPER CELLS; CYTOKINES; DERMATOMYOSITIS; GENE EXPRESSION