It has been reported that GZMK can induce signaling pathways associated with the onset of inflammation.[16] Of note, increased frequency of GZMK+ CD8 T cells has been associated with inflammatory status across several physiological and pathological conditions, predominantly in the peripheral blood of aging people,[17] in the synovial tissue of rheumatoid arthritis (RA) patients,[18] and in the kidney of lupus nephritis patients.[19] Clearly, more studies are needed to further explore the role of GZMK+ T cells in MDA5+DM patients. This evidence concerns the gene IFIH1 and lupus nephritis.