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Updated: Jun 28, 2025
Immunolabelling Myofiber Degeneration in Muscle Biopsies
Published on: December 5, 2019
CD163+ macrophage density in perimysial connective tissue associated with prognosis in IMNM
Hui Sun1,2, Zi-Yi Wang1, Ye Han1,2
1Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, China.
Objective:
The pathological features of immune-mediated necrotizing myopathy (IMNM) are dominated by the infiltration of macrophages. We aimed to perform a histopathologic semiquantitative analysis to investigate the relationship between macrophage markers and prognosis.
Methods:
Semiquantitative analysis of histologic features was performed in 62 samples of IMNM. Independent risk factors were identified through univariate and multivariate regression analysis. Cluster analysis was performed using the partitioning around the medoids (PAM) method. Decision tree modeling was utilized to efficiently determine cluster labels for IMNM patients. The validity of the developmental cohort was assessed by accuracy in comparison with the validation cohort.
Results:
The most enriched groups in patients with IMNM were macrophages expressing CD206 and CD163. In the multivariate logistic regression model, the high density of CD163+ macrophages in perimysial connective tissue increased the risk of unfavorable prognosis (p = 0.025, OR = 1.463, 95% CI: 1.049-2.041). In cluster analysis, patients in Cluster 1, with lower CD163+ macrophage density and inflammatory burden, had a more favorable prognosis. Conversely, patients in Cluster 3, which were enriched for CD163+ macrophages in the perimysial connective tissue, had the most severe clinical features and the worst prognosis. Correlations were found between the density of CD163+ macrophages in connective tissue and symptom duration (R2 = 0.166, p < 0.001), dysphagia (p = 0.004), cardiac involvement (p = 0.021), CK (R2 = 0.067, p = 0.042), CRP (R2 = 0.117, p < 0.001), and ESR (R2 = 0.171, p < 0.001).
Conclusion:
The density of CD163+ macrophages in perimysial connective tissue may serve as a potential marker for the prediction of IMNM prognosis.
Insights
High CD163+ macrophage density in immune-mediated necrotizing myopathy (IMNM) indicates a worse prognosis. This macrophage marker in perimysial connective tissue may help predict IMNM outcomes.
Area of Science:
- Immunology
- Pathology
- Neurology
Background:
- Immune-mediated necrotizing myopathy (IMNM) is characterized by significant macrophage infiltration.
- Understanding macrophage roles is crucial for predicting IMNM progression and patient outcomes.
Purpose of the Study:
- To conduct a histopathologic semiquantitative analysis of macrophage markers in IMNM.
- To investigate the association between macrophage density and patient prognosis.
Main Methods:
- Semiquantitative analysis of 62 IMNM tissue samples.
- Univariate and multivariate regression for risk factor identification.
- Cluster analysis (PAM) and decision tree modeling for patient stratification.
Main Results:
- CD163+ macrophages were enriched in IMNM tissues.
- High density of CD163+ macrophages in perimysial connective tissue correlated with unfavorable prognosis (OR=1.463, p=0.025).
- Cluster analysis identified patient groups with varying CD163+ macrophage levels and distinct clinical features and prognoses.
Conclusions:
- CD163+ macrophage density in perimysial connective tissue is a potential prognostic marker for IMNM.
- This finding may aid in stratifying patients and tailoring treatment strategies.
