{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T04:12:09Z","timestamp":1794370329562,"version":"4.9.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"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>Background<\/jats:title>\n                    <jats:p>The development of rapidly progressive interstitial lung disease (RP-ILD) in patients with anti-MDA5-positive dermatomyositis-associated interstitial lung disease (MDA5+ DM-ILD) is a major cause of adverse outcomes, including mortality. This study aimed to identify factors influencing the occurrence of RP-ILD in patients with MDA5+ DM-ILD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted in PubMed, EMBASE, the Cochrane Library, Web of Science, and Scopus for studies investigating factors associated with RP-ILD in MDA5+ DM-ILD, with the search period extending to January 1, 2026. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using Stata 18.0 software.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifteen studies were included in the meta-analysis, all of which were of high quality, with an average NOS score of 7.9. The meta-analysis revealed that male sex (OR\u00a0=\u00a01.99, 95% CI: 1.27-3.12), advanced age (OR\u00a0=\u00a02.54, 95% CI: 1.40-4.60), disease duration &amp;lt;3 months (OR\u00a0=\u00a03.23, 95% CI: 2.23-4.70), fever (OR\u00a0=\u00a02.46, 95% CI: 1.55-3.90), anti-Ro52 antibody positivity (OR\u00a0=\u00a05.05, 95% CI: 3.21-7.96), elevated C-reactive protein (CRP) (OR\u00a0=\u00a02.29, 95% CI: 1.78-2.94), elevated neutrophil-to-lymphocyte ratio (NLR) (OR\u00a0=\u00a02.29, 95% CI: 1.28-4.08), elevated lactate dehydrogenase (LDH) (OR\u00a0=\u00a03.39, 95% CI: 2.20-5.22), elevated aspartate aminotransferase (AST) (OR\u00a0=\u00a01.03, 95% CI: 1.00-1.06), elevated alanine aminotransferase (ALT) (OR\u00a0=\u00a02.42, 95% CI: 1.22-4.80), elevated serum ferritin (SF) (OR\u00a0=\u00a03.81, 95% CI: 1.95-7.42), lymphopenia (OR\u00a0=\u00a02.14, 95% CI: 1.10-4.16), and elevated carcinoembryonic antigen (CEA) (OR\u00a0=\u00a03.38, 95% CI: 1.32-8.66) were risk factors for RP-ILD. Conversely, arthralgia\/arthritis (OR\u00a0=\u00a00.26, 95% CI: 0.16-0.44) and lymphocytosis (OR\u00a0=\u00a00.17, 95% CI: 0.09-0.31) were identified as potential protective factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study explored potential risk and protective factors associated with the development of RP-ILD in patients with MDA5+ DM-ILD, providing a basis for early identification and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:uri>\n                      , identifier CRD420261287925.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1796496","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:05:58Z","timestamp":1775801158000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Influencing factors for rapidly progressive interstitial lung disease in patients with anti-MDA5 antibody-positive dermatomyositis: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Haixia","family":"Li","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"The First Clinical Medical College, Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province and Ministry of Education of P. 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China, Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyang","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"The First Clinical Medical College, Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gao","family":"Da","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Medicine, The Third Affiliated Hospital of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"The First Clinical Medical College, Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The First Affiliated Hospital of Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"The First Clinical Medical College, Henan University of Chinese Medicine","place":["Zhengzhou, Henan, China"]},{"name":"Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province and Ministry of Education of P. 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