{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T15:42:50Z","timestamp":1793720570133,"version":"4.6.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to evaluate the clinical characteristics and prognostic significance of serum lactate dehydrogenase (LDH) in patients with anti-MDA5+ dermatomyositis (anti-MDA5+ DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We assessed 246 consecutive patients with anti-MDA5+ DM. The patients were divided into two groups based on LDH levels: the LDH \u2264 338 U\/L group and the LDH &amp;gt; 338 U\/L group. We compared the clinical characteristics, laboratory findings, and long-term prognosis between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, the one-year mortality rate in patients with anti-MDA5+ DM was high, at 24.39% (60\/246). LDH levels exhibited a nonlinear, inverted S-shaped relationship with the overall mortality risk in anti-MDA5+ DM patients (nonlinear P = 0.001). Patients in the LDH &amp;gt; 338 U\/L group had significantly higher levels of ALT [64.0 (32.0, 121.0) vs 40.0 (23.0, 66.5), P&amp;lt;0.001], AST [75.0 (47.5, 134.0) vs 40.0 (26.0, 60.6), P&amp;lt;0.001], CK [107.0 (42.0, 208.8) vs 50.0 (35.5, 100.5), P&amp;lt;0.001], CRP [8.5 (3.5, 17.6) vs 4.7 (2.7, 10.2), P&amp;lt;0.001], and serum ferritin levels [1307.6 (679.8, 1565.5) vs 1001.0 (391.2, 1307.6), P&amp;lt;0.001] compared to the LDH \u2264 338 U\/L group. Additionally, the positivity rate of Anti-Ro52 antibodies (70.7% vs 57.7%, P = 0.033), the incidence of rapidly progressive interstitial lung disease (RPILD) (42.3% vs 29.3%, P = 0.033), and the mortality rate (35.0% vs 13.8%, P&amp;lt;0.001) were significantly higher in the LDH &amp;gt; 338 U\/L group than in the LDH \u2264 338 U\/L group. Multivariable regression analysis revealed that LDH &amp;gt; 338 U\/L and the presence of RPILD were associated with poor prognosis [hazard ratios of 2.253 (95% CI 1.258, 4.035, P = 0.006) and 10.293 (95% CI 4.683, 22.623, P &amp;lt; 0.001), respectively].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with different LDH levels exhibit distinct clinical characteristics, laboratory findings, and long-term prognosis. Elevated LDH levels (&amp;gt; 338 U\/L) and the presence of RPILD are associated with poor prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1642682","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T06:29:57Z","timestamp":1762756197000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Serum lactate dehydrogenase and rapidly progressive interstitial lung disease are associated with increased mortality in anti-melanoma differentiation-associated gene 5 antibody-positive 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