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Several cases of dermatomyositis (DM) associated with mRNA vaccination against SARS-CoV-2 infection have been reported. The question is whether there is a common pathomechanism for the induction of DM by this mRNA vaccination. The aim of this review is to analyse the sample of previously published case reports of DM following COVID-19 mRNA vaccination for common indicators of a possible immune pathomechanism.<\/jats:p><jats:p>In this review, we summarised case reports of DM following mRNA vaccination against COVID-19. We considered this case report landscape as a cumulative sample (<jats:italic>n<\/jats:italic>\u2009=\u200932) and identified common clinical and molecular parameters in the intersection of case reports and statistically analysed the effect of these parameters on the development of DM.<\/jats:p><jats:p>MDA-5 antibodies seem to play a role in the autoantibody signature after mRNA vaccination. MDA-5-positive DM is statistically more strongly associated with mRNA vaccination and interstitial lung disease\/rapidly progressive interstitial lung disease (ILD\/RP-ILD) than MDA-5-negative DM. MDA-5-positive DM seems not to be associated with an increased risk of malignancy, whereas MDA-5-negative DM is more strongly associated with malignancy.<\/jats:p><jats:p>Our findings emphasize the potential role of innate antiviral signalling pathways in connecting DM to mRNA vaccination. MDA-5 autoantibodies appear to be predictive of a severe DM progression following mRNA vaccination. There seems to be an association between MDA-5 autoantibodies and paraneoplastic DM post-vaccination. Further studies are required to uncover the underlying mechanisms of autoimmunity triggered by mRNA vaccination.<\/jats:p>","DOI":"10.1007\/s00296-024-05683-5","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T12:30:38Z","timestamp":1724761838000},"page":"2185-2196","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Anti-MDA5 autoantibodies predict clinical dynamics of dermatomyositis following SARS-CoV-2 mRNA vaccination: a retrospective statistical analysis of case reports"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1306-7775","authenticated-orcid":false,"given":"Christian R.","family":"Klein","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5298-9880","authenticated-orcid":false,"given":"Annkristin","family":"Heine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9324-5527","authenticated-orcid":false,"given":"Peter","family":"Brossart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8421-2745","authenticated-orcid":false,"given":"Pantelis","family":"Karakostas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6591-5936","authenticated-orcid":false,"given":"Valentin Sebastian","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,27]]},"reference":[{"key":"5683_CR1","doi-asserted-by":"publisher","unstructured":"Mammen AL, Allenbach Y, Stenzel W, Benveniste O, Allenbach Y, Benveniste O et al (2020) 239th ENMC international workshop: classification of dermatomyositis, Amsterdam, the Netherlands, 14\u201316 December 2018. 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