Candidate molecular endotypes and dynamic risk prediction in anti-MDA5-positive dermatomyositis-associated interstitial lung disease: a systematic scoping review
- 1First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
- 2National Clinical Research Center for Chinese Medicine
Abstract
Background: Anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis (anti-MDA5+ DM) spans pulmonary states from no detectable interstitial lung disease (ILD) to rapidly progressive ILD (RP-ILD). We mapped molecular programs and prediction evidence to determine how recurrent biological states may support dynamic stratification.
Methods: PubMed, Web of Science, Ovid and Embase were searched from inception to 22 August 2026. Two reviewers independently screened records and extracted data. Reporting followed PRISMA-ScR; evidence was synthesized across molecular and prediction domains.
Results: Of 4, 166 records, 2, 317 remained after deduplication, 349 underwent full-text assessment, and 95 sources (80 primary studies and 15 syntheses) were included. Type I/III interferon signaling was the most reproducible program. Myeloid inflammatory-remodeling, adaptive activation with lymphocyte or natural-killer-cell loss, vascular-coagulation injury, and immunometabolic disturbance formed additional overlapping axes aligned with pulmonary-state transitions. Clinical and radiomic models showed strong short-term discrimination; harmonized landmarks, calibration, geographic validation, and decision-timed molecular sampling would strengthen clinical use.
Conclusion: The evidence supports an integrated map linking recurrent molecular programs to dynamic pulmonary risk. A calibrated clinical–imaging backbone, augmented by parsimonious molecular modules with incremental value and updated at prespecified landmarks, offers a practical framework for prospective endotype validation and treatment-aware prediction in anti-MDA5+ DM-ILD.
Systematic review registration: https://doi.org/10.37766/inplasy2026.10.0018 , identifier INPLASY2026100018.
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BibTeX
@article{zuo2026candidate,
title = {{Candidate molecular endotypes and dynamic risk prediction in anti-MDA5-positive dermatomyositis-associated interstitial lung disease: a systematic scoping review}},
author = {Zhiwei Zuo and Jianguo Yang and Jianbin Li and Renhe Li and Wei Liu},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1979138},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1979138/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Candidate molecular endotypes and dynamic risk prediction in anti-MDA5-positive dermatomyositis-associated interstitial lung disease: a systematic scoping review
AU - Zhiwei Zuo
AU - Jianguo Yang
AU - Jianbin Li
AU - Renhe Li
AU - Wei Liu
PY - 2026
DA - 2026/10/09
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1979138
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1979138/full
AB - Background: Anti-melanoma differentiation-associated protein 5 antibody-positive dermatomyositis (anti-MDA5+ DM) spans pulmonary states from no detectable interstitial lung disease (ILD) to rapidly progressive ILD (RP-ILD). We mapped molecular programs and prediction evidence to determine how recurrent biological states may support dynamic stratification. Methods: PubMed, Web of Science, Ovid and Embase were searched from inception to 22 August 2026. Two reviewers independently screened records and extracted data. Reporting followed PRISMA-ScR; evidence was synthesized across molecular and prediction domains. Results: Of 4, 166 records, 2, 317 remained after deduplication, 349 underwent full-text assessment, and 95 sources (80 primary studies and 15 syntheses) were included. Type I/III interferon signaling was the most reproducible program. Myeloid inflammatory-remodeling, adaptive activation with lymphocyte or natural-killer-cell loss, vascular-coagulation injury, and immunometabolic disturbance formed additional overlapping axes aligned with pulmonary-state transitions. Clinical and radiomic models showed strong short-term discrimination; harmonized landmarks, calibration, geographic validation, and decision-timed molecular sampling would strengthen clinical use. Conclusion: The evidence supports an integrated map linking recurrent molecular programs to dynamic pulmonary risk. A calibrated clinical–imaging backbone, augmented by parsimonious molecular modules with incremental value and updated at prespecified landmarks, offers a practical framework for prospective endotype validation and treatment-aware prediction in anti-MDA5+ DM-ILD. Systematic review registration: https://doi.org/10.37766/inplasy2026.10.0018 , identifier INPLASY2026100018.
SN - 1664-3224
ER -