The emerging role of growth differentiation factor 15 as a potential disease biomarker in juvenile dermatomyositis

Objective: We aimed to investigate the potential of growth differentiation factor 15 (GDF-15) as a novel biomarker for disease activity in JDM.Methods: We recruited children with juvenile myositis including JDM (n = 77), PM (n = 6) and healthy controls (n = 22). GDF-15 levels in plasma were measured using ELISA. Statistical analyses were performed using non-parametric tests.Results: Levels of GDF-15 were significantly elevated in JDM compared with healthy controls (P < 0.001). GDF-15 levels exhibited strong positive correlations with DASs, including the DAS total score, DAS skin score, DAS muscle score and Childhood Myositis Assessment Scale. Additionally, GDF-15 levels could differentiate between active disease and remission based on the Physician Global Assessment of muscle score. Positive correlations were observed between levels of GDF-15 and creatine kinase, neopterin and nailfold end row loops, indicating the potential involvement of GDF-15 in muscle damage, immune activation and vascular pathology. Receiver operating characteristics curve analysis showed GDF-15 to be more effective in assessing disease activity in JDM than creatine kinase [area under the curve (AUC) 0.77, P = 0.001 and AUC 0.6369, P = 0.0738, respectively].Conclusion: GDF-15 may serve as a valuable biomarker for assessing disease activity in JDM. It exhibits better sensitivity and specificity than creatine kinase and the levels correlate with various DASs and functional measures. GDF-15 may provide valuable information for treatment decision making and monitoring disease progression in JDM.