Top

Clinical Rheumatology

Published in:

01-08-2019 | Polymyositis | Original Article

The spectrum and clinical significance of myositis-specific autoantibodies in Chinese patients with idiopathic inflammatory myopathies

Authors: Shanshan Li, Yongpeng Ge, Hanbo Yang, Tao Wang, Xiaoxiao Zheng, Qinglin Peng, Xin Lu, Guochun Wang

Published in: Clinical Rheumatology | Issue 8/2019

Abstract

Objectives

The aim of this study is to analyze the prevalence of myositis-specific autoantibodies (MSAs) and to elucidate their associations with clinical features in Chinese patients with polymyositis (PM) and dermatomyositis (DM).

Methods

Twelve subsets of MSAs including anti-Mi-2, anti-TIF1-γ, anti-MDA5, anti-NXP2, anti-SAE1, anti-SRP, anti-Jo-1, anti-PL-7, anti-PL-12, anti-EJ, anti-OJ, and anti-HMGCR antibodies were tested. Four hundred and ninety-seven PM/DM patients were enrolled. Clinical features and laboratory data were collected. The frequency of MSAs and the correlations with clinical phenotypes were calculated by SPSS 21.0.

Results

MSAs were present in 65.4% in PM/DM patients. Anti-TIF1-γ (14.3%), anti-MDA5 (12.5%), and anti-Jo-1 (10.1%) were the three commonest MSAs. Anti-SAE1 (OR 14.877, 95% CI 1.427–155.074), anti-SRP (OR 4.339, 95% CI 1.529–12.312) and anti-TIF1-γ (OR 2.790, 95% CI 1.578–4.935) were associated with dysphagia. In contrast, anti-MDA5 (OR 0.356, 95% CI 0.148–0.856) might decrease the frequency of this manifestation. Interstitial lung disease (ILD) was observed more frequently in patients carrying anti-EJ (OR 14.202, 95% CI 1.696–118.902), anti-Jo-1 (OR 11.111, 95% CI 3.306–37.335), and anti-MDA5 (OR 3.109, 95% CI 1.578–6.128). On the contrary, anti-Mi-2 (OR 0.180, 95% CI 0.055–0.589), anti-TIF1-γ (OR 0.163, 95% CI 0.080–0.333), and anti-HMGCR (OR 0.058, 95% CI 0.007–0.451) were protective factors against developing ILD. Anti-TIF1-γ was an independent risk factor for cancer-associated myositis (OR 4.237, 95% CI 1.712–10.487).

Conclusions

PM/DM patients had high frequencies of MSAs. Several MSAs were independent factors in determining unique clinical phenotypes.

Available only for authorised users

Dimachkie MM, Barohn RJ, Amato AA (2014) Idiopathic inflammatory myopathies. Neurol Clin 32:595–628CrossRefPubMedPubMedCentral

Hoogendijk JE, Amato AA, Lecky BR, Choy EH, Lundberg IE, Rose MR, Vencovsky J, de Visser M, Hughes RA (2004) 119th ENMC International Workshop: trial design in adult idiopathic inflammatory myopathies, with the exception of inclusion body myositis, 10-12 October 2003, Naarden, The Nertherlands. Neuromuscul Disord 14:337–345CrossRefPubMed

Ghirardello A, Bassi N, Palma L, Borella E, Domeneghetti M, Punzi L, Doria A (2013) Autoantibodies in polymyositis and dermatomyositis. Curr Rheumatol Rep 15(335):335CrossRefPubMed

Tansley SL, Betteridge ZE, McHugh NJ (2013) The diagnostic utility of autoantibodies in adult and juvenile myositis. Curr Opin Rheumatol 25:772–777CrossRefPubMed

Hall JC, Casciola-Rosen L, Samedy LA, Werner J, Owoyemi K, Danoff SK, Christopher-Stine L (2013) Anti-melanoma differentiation-associated protein 5-associated dermatomyositis: expanding the clinical spectrum. Arthritis Care Res (Hoboken) 65:1307–1315CrossRef

Koga T, Fujikawa K, Horai Y, Okada A, Kawashiri SY, Iwamoto N, Suzuki T, Nakashima Y, Tamai M, Arima K, Yamasaki S, Nakamura H, Origuchi T, Hamaguchi Y, Fujimoto M, Ishimatsu Y, Mukae H, Kuwana M, Kohno S, Eguchi K, Aoyagi K, Kawakami A (2012) The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM. Rheumatology (Oxford) 51:1278–1284CrossRef

Cao H, Pan M, Kang Y, Xia Q, Li X, Zhao X, Shi R, Lou J, Zhou M, Kuwana M, Ding X, Zheng J (2012) Clinical manifestations of dermatomyositis and clinically amyopathic dermatomyositis patients with positive expression of anti-melanoma differentiation-associated gene 5 antibody. Arthritis Care Res (Hoboken). 64:1602–1610CrossRefPubMed

Labrador-Horrillo M, Martinez MA, Selva-O’Callaghan A, Trallero-Araguas E, Balada E, Vilardell-Tarres M et al (2014) Anti-MDA5 antibodies in a large Mediterranean population of adults with dermatomyositis. J Immunol Res 2014:290797CrossRefPubMedPubMedCentral

Chen Z, Hu W, Wang Y, Guo Z, Sun L, Kuwana M (2015) Distinct profiles of myositis-specific autoantibodies in Chinese and Japanese patients with polymyositis/dermatomyositis. Clin Rheumatol 34:1627–1631CrossRefPubMed

10.

Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (first of two parts). N Engl J Med 292:344–347CrossRefPubMed

11.

Sontheimer RD (2002) Dermatomyositis: an overview of recent progress with emphasis on dermatologic aspects. Dermatol Clin 20:387–408CrossRefPubMed

12.

Cruellas MG, Viana Vdos S, Levy-Neto M, Souza FH, Shinjo SK (2013) Myositis-specific and myositis-associated autoantibody profiles and their clinical associations in a large series of patients with polymyositis and dermatomyositis. Clinics (Sao Paulo) 68:909–914CrossRef

13.

Nakajima A, Yoshino K, Soejima M, Kawaguchi Y, Satoh T, Kuwana M, Yamanaka H (2012) High frequencies and co-existing of myositis-specific autoantibodies in patients with idiopathic inflammatory myopathies overlapped to rheumatoid arthritis. Rheumatol Int 32:2057–2061CrossRefPubMed

14.

Zampeli E, Venetsanopoulou A, Argyropoulou OD, Mavragani CP, Tektonidou MG, Vlachoyiannopoulos PG, Tzioufas AG, Skopouli FN, Moutsopoulos HM (2018) Myositis autoantibody profiles and their clinical associations in Greek patients with inflammatory myopathies. Clin Rheumatol 38:125–132. https://doi.org/10.1007/s10067-018-4267-z CrossRefPubMed

15.

So H, Ip RW, Wong VT, Yip RM (2018) Analysis of anti-melanoma differentiation-associated gene 5 antibody in Hong Kong Chinese patients with idiopathic inflammatory myopathies: diagnostic utility and clinical correlations. Int J Rheum Dis 21:1076–1081CrossRefPubMed

16.

Fujimoto M, Murakami A, Kurei S, Okiyama N, Kawakami A, Mishima M, Sato S, Seishima M, Suda T, Mimori T, Takehara K, Kuwana M (2016) Enzyme-linked immunosorbent assays for detection of anti-transcriptional intermediary factor-1 gamma and anti-Mi-2 autoantibodies in dermatomyositis. J Dermatol Sci 84:272–281CrossRefPubMed

17.

Ge Y, Lu X, Peng Q, Shu X, Wang G (2015) Clinical characteristics of anti-3-hydroxy-3-methylglutaryl coenzyme A reductase antibodies in Chinese patients with idiopathic inflammatory myopathies. PLoS One 10:e0141616CrossRefPubMedPubMedCentral

18.

Ghirardello A, Borella E, Beggio M, Franceschini F, Fredi M, Doria A (2014) Myositis autoantibodies and clinical phenotypes. Auto Immun Highlights 5:69–75CrossRefPubMedPubMedCentral

19.

Muro Y, Sugiura K, Akiyama M (2016) Cutaneous manifestations in dermatomyositis: key clinical and serological features-a comprehensive review. Clin Rev Allergy Immunol 51:293–302CrossRefPubMed

20.

Gunawardena H, Wedderburn LR, North J, Betteridge Z, Dunphy J, Chinoy H, Davidson JE, Cooper RG, McHugh N, Juvenile Dermatomyositis Research Group UK (2008) Clinical associations of autoantibodies to a p155/140 kDa doublet protein in juvenile dermatomyositis. Rheumatology (Oxford) 47:324–328CrossRef

21.

Cao H, Xia Q, Pan M, Zhao X, Li X, Shi R, Zhou M, Ding X, Kuwana M, Zheng J (2016) Gottron papules and Gottron sign with ulceration: a distinctive cutaneous feature in a subset of patients with classic dermatomyositis and clinically amyopathic dermatomyositis. J Rheumatol 43:1735–1742CrossRefPubMed

22.

Basharat P, Christopher-Stine L (2015) Immune-mediated necrotizing myopathy: update on diagnosis and management. Curr Rheumatol Rep 17:72CrossRefPubMed

23.

Ishigaki K, Maruyama J, Hagino N, Murota A, Takizawa Y, Nakashima R, Mimori T, Setoguchi K (2013) Skin ulcer is a predictive and prognostic factor of acute or subacute interstitial lung disease in dermatomyositis. Rheumatol Int 33:2381–2389CrossRefPubMed

24.

Fiorentino D, Chung L, Zwerner J, Rosen A, Casciola-Rosen L (2011) The mucocutaneous and systemic phenotype of dermatomyositis patients with antibodies to MDA5 (CADM-140): a retrospective study. J Am Acad Dermatol 65:25–34CrossRefPubMedPubMedCentral

25.

Ichimura Y, Matsushita T, Hamaguchi Y, Kaji K, Hasegawa M, Tanino Y, Inokoshi Y, Kawai K, Kanekura T, Habuchi M, Igarashi A, Sogame R, Hashimoto T, Koga T, Nishino A, Ishiguro N, Sugimoto N, Aoki R, Ando N, Abe T, Kanda T, Kuwana M, Takehara K, Fujimoto M (2012) Anti-NXP2 autoantibodies in adult patients with idiopathic inflammatory myopathies: possible association with malignancy. Ann Rheum Dis 71:710–713CrossRefPubMed

26.

Bodoki L, Nagy-Vincze M, Griger Z, Betteridge Z, Szöllősi L, Dankó K (2014) Four dermatomyositis-specific autoantibodies-anti-TIF1-γ, anti-NXP2, anti-SAE and anti-MDA5-in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort. Autoimmun Rev 13:1211–1219CrossRefPubMed

27.

Valenzuela A, Chung L, Casciola-Rosen L, Fiorentino D (2014) Identification of clinical features and autoantibodies associated with calcinosis in dermatomyositis. JAMA Dermatol 150:724–729CrossRefPubMedPubMedCentral

28.

Gunawardena H, Betteridge ZE, McHugh NJ (2009) Myositis-specific autoantibodies: their clinical and pathogenic significance in disease expression. Rheumatology (Oxford) 48:607–612CrossRef

29.

Dobloug C, Garen T, Bitter H, Stjärne J, Stenseth G, Grøvle L, Sem M, Gran JT, Molberg Ø (2015) Prevalence and clinical characteristics of adult polymyositis and dermatomyositis; data from a large and unselected Norwegian cohort. Ann Rheum Dis 74:1551–1556CrossRefPubMed

30.

Cavazzana I, Fredi M, Selmi C, Tincani A, Franceschini F (2017) The clinical and histological Spectrum of idiopathic inflammatory myopathies. Clin Rev Allergy Immunol 52:88–98CrossRefPubMed

31.

Rider LG, Shah M, Mamyrova G, Huber AM, Rice MM, Targoff IN, Miller FW, Childhood Myositis Heterogeneity Collaborative Study Group (2013) The myositis autoantibody phenotypes of the juvenile idiopathic inflammatory myopathies. Medicine (Baltimore) 92:223–243CrossRef

32.

Satoh M, Tanaka S, Ceribelli A, Calise SJ, Chan EK (2017) A comprehensive overview on myositis-specific antibodies: new and old biomarkers in idiopathic inflammatory myopathy. Clin Rev Allergy Immunol 52:1–19CrossRefPubMedPubMedCentral

33.

Hallowell RW, Danoff SK (2014) Interstitial lung disease associated with the idiopathic inflammatory myopathies and the antisynthetase syndrome: recent advances. Curr Opin Rheumatol 26:684–689CrossRefPubMed

34.

Kiely PD, Chua F (2013) Interstitial lung disease in inflammatory myopathies: clinical phenotypes and prognosis. Curr Rheumatol Rep 15:359CrossRefPubMed

35.

Moghadam-Kia S, Oddis CV, Sato S, Kuwana M, Aggarwal R (2016) Anti-MDA5 is associated with rapidly progressive lung disease and poor survival in U.S. patients with amyopathic and myopathic dermatomyositis. Arthritis Care Res (Hoboken). 68:689–694CrossRefPubMedPubMedCentral

36.

Kalluri M, Sahn SA, Oddis CV, Gharib SL, Christopher-Stine L, Danoff SK, Casciola-Rosen L, Hong G, Dellaripa PF, Highland KB (2009) Clinical profile of anti-PL-12 autoantibody. Cohort study and review of the literature. Chest. 135:1550–1556CrossRefPubMed

37.

García-De La Torre I (2015) Clinical usefulness of autoantibodies in idiopathic inflammatory myositis. Front Immunol 6:331CrossRefPubMedPubMedCentral

38.

Trallero-Araguás E, Rodrigo-Pendás JA, Selva-O’Callaghan A, Martínez-Gómez X, Bosch X, Labrador-Horrillo M et al (2012) Usefulness of anti-p155 autoantibody for diagnosing cancer-associated dermatomyositis: a systematic review and meta-analysis. Arthritis Rheum 64:523–532CrossRefPubMed

39.

Fiorentino DF, Chung LS, Christopher-Stine L, Zaba L, Li S, Mammen AL, Rosen A, Casciola-Rosen L (2013) Most patients with cancer-associated dermatomyositis have antibodies to nuclear matrix protein NXP-2 or transcription intermediary factor 1 γ. Arthritis Rheum 65:2954–2962CrossRefPubMedPubMedCentral

40.

Lu X, Yang H, Shu X, Chen F, Zhang Y, Zhang S, Peng Q, Tian X, Wang G (2014) Factors predicting malignancy in patients with polymyositis and dermatomyositis: a systematic review and meta-analysis. PLoS One 9:e94128CrossRefPubMedPubMedCentral

41.

Danieli MG, Gelardi C, Guerra F, Cardinaletti P, Pedini V, Gabrielli A (2016) Cardiac involvement in polymyositis and dermatomyositis. Autoimmun Rev 15:462–465CrossRefPubMed

42.

Wang L, Huang L, Yang Y, Chen H, Liu Y, Liu K, Liu M, Xiao Y, Luo H, Zuo X, Li Y, Xiao X, Zhang H (2018) Calcinosis and malignancy are rare in Chinese adult patients with myositis and nuclear matrix protein 2 antibodies identified by an unlabeled immunoprecipitation assay. Clin Rheumatol 37:2731–2739CrossRefPubMed

43.

Muro Y, Sugiura K, Hoshino K, Akiyama M (2012) Disappearance of anti-MDA-5 autoantibodies in clinically amyopathic DM/interstitial lung disease during disease remission. Rheumatology (Oxford) 51:800–804CrossRef

44.

Marie I, Hatron PY, Cherin P, Hachulla E, Diot E, Vittecoq O, Menard JF, Jouen F, Dominique S (2013) Functional outcome and prognostic factors in anti-Jo-1 patients with antisynthetase syndrome. Arthritis Res Ther 15:R149CrossRefPubMedPubMedCentral

45.

Cavazzana I, Fredi M, Ceribelli A, Mordenti C, Ferrari F, Carabellese N, Tincani A, Satoh M, Franceschini F (2016) Testing for myositis specific autoantibodies: comparison between line blot and immunoprecipitation assays in 57 myositis sera. J Immunol Methods 433:1–5CrossRefPubMed

Title: The spectrum and clinical significance of myositis-specific autoantibodies in Chinese patients with idiopathic inflammatory myopathies
Authors: Shanshan Li
Yongpeng Ge
Hanbo Yang
Tao Wang
Xiaoxiao Zheng
Qinglin Peng
Xin Lu
Guochun Wang
Publication date: 01-08-2019
Publisher: Springer London
Keywords: Polymyositis
Diseases of the neuromuscular synapses and muscles
Polymyositis
Dermatomyositis
Dysphagia
Dysphagia
Dysphagia
Myopathy
Published in: Clinical Rheumatology / Issue 8/2019
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04503-7

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The spectrum and clinical significance of myositis-specific autoantibodies in Chinese patients with idiopathic inflammatory myopathies

Abstract

Objectives

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2019

Meta-analysis in the era of big data

Cardiac and cardiovascular morbidities in patients with psoriatic arthritis: a population-based case control study

Diffuse pruritic erythema as a clinical manifestation in anti-SAE antibody-associated dermatomyositis: a case report and literature review

Burden of comorbidities in South Africans with systemic lupus erythematosus

A misdiagnosed case of antisynthetase syndrome complicated by myocarditis: when the cardiologist deals with rheumatology

Prognostic factors associated with early gout flare recurrence in patients initiating urate-lowering therapy during an acute gout flare

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page