A high level of serum neopterin is associated with rapidly progressive interstitial lung disease and reduced survival in dermatomyositis.
Neopterin is primarily synthesized and released by activated macrophages/monocytes upon stimulation with interferon-γ and is considered as a marker for macrophage activation. This study aimed to analyze the serum levels of neopterin in patients with dermatomyositis (DM) in association with clinical manifestations, laboratory data and patient prognosis. One hundred and eighty-two consecutive DM patients and 30 healthy controls were retrospectively enrolled into the study. Serum levels of neopterin were significantly increased in DM patients compared to healthy controls (P < 0·001). High serum neopterin levels were associated with anti-melanoma differentiation-associated gene (MDA5) antibody, rapidly progressive interstitial lung disease (RP-ILD) and characteristic DM cutaneous involvement. Longitudinal assessment of serum samples revealed that the serum neopterin levels were closely correlated with disease severity (β = 30·24, P < 0·001). In addition, a significant increase in serum neopterin concentration of non-survivors was observed when compared to that of survivors (P < 0·001). Receiver operator characteristic curves showed that serum neopterin could distinguish non-survivors and survivors at an optimal cut-off level of 22·1 nmol/l with a sensitivity and specificity of 0·804 and 0·625, respectively (P < 0·001). Kaplan-Meier survival curves revealed that DM patients with serum neopterin > 22·1 nmol/l had a significantly higher mortality compared to the patient group with serum neopterin < 22·1 nmol/l (log-rank P < 0·001). Multivariate regression analysis identified high serum neopterin concentration to be an independent risk factor for poor prognosis in DM (adjusted hazard ratio = 4·619, 95% confidence interval = 2·092-10·195, P < 0·001). In conclusion, increased serum levels of neopterin were significantly associated with RP-ILD and reduced survival in DM patients, suggesting it as a promising biomarker in disease evaluation of DM.
['Peng|Q-L|QL|0000-0002-1271-1729', 'Zhang|Y-M|YM|', 'Liang|L|L|', 'Liu|X|X|', 'Ye|L-F|LF|', 'Yang|H-B|HB|', 'Zhang|L|L|', 'Shu|X-M|XM|', 'Lu|X|X|', 'Wang|G-C|GC|']
D000328:Adult D015415:Biomarkers D003882:Dermatomyositis D018450:Disease Progression D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D017563:Lung Diseases, Interstitial D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D019798:Neopterin D011379:Prognosis D012044:Regression Analysis D012189:Retrospective Studies D012307:Risk Factors D012680:Sensitivity and Specificity
neopterin rapidly progressive interstitial lung disease dermatomyositis prognostic factor