Skip to main content
Log in

Myositis-specific and myositis-associated autoantibodies in Indian patients with inflammatory myositis

  • Epidemiology of RMD
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

We aimed to study the prevalence and clinical associations of myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs) in a large cohort of Indian patients with idiopathic inflammatory myositis (IIM). Clinical details and serum samples were collected from patients with IIM (satisfying Bohan and Peter Criteria, 1975) and CTD-associated myositis. Sera were analysed for antibodies against SRP, Mi2, Jo1, PL7, PL12, EJ, OJ, Ro52, Ku, Pm-Scl 75 and PM-Scl 100, using immunoblot assay. The cohort comprised 124 patients with IIM (M:F = 1:3.6). Fifty-five of them had dermatomyositis (DM), 22 had juvenile dermatomyositis (JDM), 25 had polymyositis (PM) and 22 had connective tissue disease-associated myositis (CTD myositis). Mean disease duration was 10.9 months. ANA was positive in 84 (68.9 %), and MSAs in 61 (49.2 %) patients. Among MSAs, autoantibodies to Mi2, synthetase (Jo1, PL7, PL12, EJ) and SRP were present in 26 (20.9 %), 29 (23.4 %) and 6 (4.8 %) patients, respectively. Prevalence of MAAs was as follows: antibodies to Ro52 in 45 (36.3 %), Ku and PM-Scl 75 in 13 (10.5 %) and PM-Scl 100 in 5 (4 %) patients. Anti-Mi2 antibodies were positively associated with DM (21/55, 38.2 %; p < 0.0001) and pharyngeal weakness (13/34, 38.2 %; p = 0.004) and negatively associated with ILD (0/28; p = 0.001). ILD and mechanics’ hands were significantly more in patients with anti-synthetase antibodies (16/28, 57 % and 14/22, 63.6 %; p < 0.0001). Four of six patients with anti-SRP antibody showed poor response to multiple drugs. Higher prevalence of anti-Mi2 is probably related to higher proportion of patients with DM. Absence of ILD in patients with anti-Mi2 antibody suggests that it may protect against ILD. In Indian population also, anti-synthetase antibodies are associated with ILD, and anti-SRP antibodies with poor response to treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Oddis CV, Conte CG, Steen VD, Medsger TA Jr (1990) Incidence of polymyositis-dermatomyositis: a 20-year study of hospital diagnosed cases in Allegheny County, PA 1963–1982. J Rheumatol 17:1329–1334

    CAS  PubMed  Google Scholar 

  2. Weitoft T (1997) Occurrence of polymyositis in the country of Gavleborg, Sweden. Scand J Rheumatol 26:104–106

    Article  CAS  PubMed  Google Scholar 

  3. Targoff IN (2002) Idiopathic inflammatory myopathy: autoantibody update. Curr Rheum Rep 4:434–441

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  5. Satoh M, Tanaka S, Ceribelli A, Calise SJ, Chan EK. Comprehensive overview of myositis specific antibodies: new and old biomarkers in idiopathic inflammatory myoopathy. Clin Rev Allergy Immunol. 2015 Sep 30. [Epub ahead of print]

  6. Kao AH, Lacomis D, Lucas M, Fertig N, Oddis CV (2004) Anti-signal recognition particle autoantibody in patients with and patients without idiopathic inflammatory myopathy. Arthritis Rheum 50:209–215

    Article  CAS  PubMed  Google Scholar 

  7. Ranque B, Authier FJ, Le Guem V, Pagnoux C, Berezne A, Allanore Y et al (2009) A descriptive and prognostic study of systemic sclerosis-associated myopathies. Ann Rheum Dis 68:1474–1477

    Article  CAS  PubMed  Google Scholar 

  8. Troyanov Y, Targoff IN, Tremblay JL, Goulet JR, Raymond Y, Senécal JL (2005) Novel classification of idiopathic inflammatory myopathies based on overlap syndrome features and autoantibodies: analysis of 100 French Canadian patients. Medicine (Baltimore) 84:231–249

    Article  Google Scholar 

  9. Brouwer R, Vree EW, Jongen PH, van-Engelen BG, van Venrooij WJ (1998) Frequent occurrence of anti-tRNA(His) autoantibodies that recognize a conformational epitope in sera of patients with myositis. Arthritis Rheum 41:1428–1437

    Article  CAS  PubMed  Google Scholar 

  10. Targoff IN, Johnson AE, Miller FW (1990) Antibody to signal recognition particle in polymyositis. Arthritis Rheum 33:1361–1370

    Article  CAS  PubMed  Google Scholar 

  11. Wade PA, Gegonne A, Jones PL, Ballestar E, Aubry F, Wolffe AP (1999) Mi-2 complex couples DNA methylation to chromatin remodelling and histone deacetylation. Nat Genet 23:62–66

    CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  13. Sordet C, Goetz J, Sibilia J (2006) Contribution of autoantibodies to the diagnosis and nosology of inflammatory muscle disease. J Bone Spine 73:646–654

    Article  CAS  Google Scholar 

  14. Nakashima R, Imura Y, Kobayashi S, Kobayashi, Shio, Hosono, Yuji, Yukawa et al (2010) A New ELISA System for detecting autoantibodies to aminoacyl-tRNA synthetases: usefulness in myositis and interstitial pneumonia. Arthritis Rheum 62(Suppl 10):1377

    Google Scholar 

  15. Ronnelid J, Barbasso Helmers S, Storfors H, Torfors H, Grip K, Rönnblom L et al (2009) Use of a commercial line blot assay as a screening test for autoantibodies in inflammatory myopathies. Autoimmun Rev 9:58–61

    Article  PubMed  Google Scholar 

  16. Ghirardello A, Rampudda M, Ekholm L, Bassi N, Tarricone E, Zampieri S et al (2010) Diagnostic performance and validation of autoantibody testing in myositis by a commercial line blot assay. Rheumatology (Oxford) 49:2370–2374

    Article  CAS  Google Scholar 

  17. Sultan Shabina M, Isenberg David A (2010) Re-classifying myositis 30 years on from Bohan and Peter. Rheumatology 49:831–833

    Article  PubMed  Google Scholar 

  18. Brouwer R, Hengstman GJ, Vree EW, Ehrfeld H, Bozic B, Ghirardello A et al (2001) Autoantibody profiles in the sera of European patients with myositis. Ann Rheum Dis 60:116–123

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Selva-O’Callaghan A, Labrador-Horrillo M, Solans-Laque R, Simeon-Aznar CP, Martínez-Gómez X, Vilardell-Tarrés M (2006) Myositis-Specific and Myositis-Associated Antibodies in a Series of Eighty-Eight Mediterranean Patients With Idiopathic Inflammatory Myopathy. Arthritis Rheum 55:791–798

    Article  PubMed  Google Scholar 

  20. Hamaguchi Y, Kuwana M, Hoshino K, Hasegawa M, Kaji K, Matsushita T et al (2011) Clinical Correlations With Dermatomyositis-Specific Autoantibodies in Adult Japanese Patients With Dermatomyositis. Arch Dermatol 142:391–398

    Article  Google Scholar 

  21. Petri MH, Satoh M, Martin-Marquez BT, Vargas-Ramírez R, Jara LJ, Saavedra MA et al (2013) Implications in the anti-Mi2 and the anti-p155/140 autoantibody prevalence in two dermatomyositis cohorts from Mexico City and Guadalajara. Arthritis Res Ther 15:R48

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Cruellas MG, Viana VS, 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 68(7):909–914

    Article  PubMed  PubMed Central  Google Scholar 

  23. Chowdhary V, Aggarwal A, Misra R (2000) Prevalence and Clinical Association of myositis specific autoantibodies in North Indian patients with idiopathic inflammatory myositis. APLAR J Rheumatol 4(2):104–107

    Google Scholar 

  24. Bohan A, Peter JB (1975) Polymyositis and dermatomyositis (second of two parts). N Engl J Med 292:403–407

    Article  CAS  PubMed  Google Scholar 

  25. Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR et al (2012) Derivation and validation of Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 64(8):2677–2686

    Article  PubMed  PubMed Central  Google Scholar 

  26. Shiboski SC, Shiboski CH, Criswell LA et al (2012) American College of Rheumatology classification criteria for Sjogren’s syndrome: a data-driven, expert consensus approach in the Sjogren’s International Collaborative Clinical Alliance Cohort. Arthritis Care Res (Hoboken) 64:475–487

    Article  CAS  Google Scholar 

  27. Amigues JM, Cantagrel A, Abbal M, Mazieres B (1996) Comparative study of 4 diagnosis criteria sets for mixed connective tissue disease in patients with anti-RNP antibodies. Autoimmunity Group of the Hospitals of Toulouse. J Rheumatol 23(12):2055–2062

    CAS  PubMed  Google Scholar 

  28. Preliminary criteria for the classification of systemic sclerosis (1980) sclero-derma. Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum 23(5):581–590

    Article  Google Scholar 

  29. Castelino FV, Varga J (2010) Interstitial lung disease in connective tissue diseases: evolving concepts of pathogenesis and management. Arthritis Res Ther 12(4):213

    Article  PubMed  PubMed Central  Google Scholar 

  30. Targoff IN, Reichlin M (1985) The association between Mi-2 antibodies and dermatomyositis. Arthritis Rheum 28:796–803

    Article  CAS  PubMed  Google Scholar 

  31. Okada S, Weatherhead E, Targoff IN, Wesley R, Miller FW (2003) Global surface ultraviolet radiation intensity may modulate the clinical and immunologic expression of autoimmune muscle disease. Arthritis Rheum 48:2285–2293

    Article  PubMed  Google Scholar 

  32. Rider LG, Miller FW, Targoff IN, Sherry DD, Samayoa E, Lindahl M et al (1994) A broadened spectrum of juvenile myositis. Myositis-specific autoantibodies in children. Arthritis Rheum 37:1534–1538

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  Google Scholar 

  34. Love LA, Leff RL, Fraser DD, Targoff IN, Dalakas M, Plotz PH et al (1991) A new approach to the classification of idiopathic inflammatory myopathy: myositis-specific autoantibodies define useful homogeneous patient groups. Medicine (Baltimore) 70:360–374

    Article  CAS  Google Scholar 

  35. Friedman AW, Targoff IN, Arnett FC (1996) Interstitial lung disease with autoantibodies against aminoacyl-tRNA synthetases in the absence of clinically apparent myositis. Semin Arthritis Rheum 26:459–467

    Article  CAS  PubMed  Google Scholar 

  36. Mileti LM, Strek ME, Niewold TB, Curran JJ, Sweiss NJ (2009) Clinical characteristics of patients with anti-Jo-1 antibodies: a single center experience. J Clin Rheumatol 15:254–255

    Article  PubMed  PubMed Central  Google Scholar 

  37. Komura K, Fujimoto M, Matsushita T, Kaji K, Kondo M, Hirano T et al (2005) Prevalence and clinical characteristics of anti-Mi-2 antibodies in Japanese patients with dermatomyositis. J Dermatol Sci 40:215–217

    Article  CAS  PubMed  Google Scholar 

  38. Miller T, Al-Lozi MT, Lopate G, Pestronk A (2002) Myopathy with antibodies to the signal recognition particle: clinical and pathological features. J Neurol Neurosurg Psychiatry 73:420–428

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Rojana-udomsart A, Mitrpant C, Bundell C, Price L, Luo YB, Fabian V et al (2013) Complement-mediated muscle cell lysis: a possible mechanism of myonecrosis in anti-SRP associated necrotizing myopathy (ASANM). J Neuroimmunol 264:65–70

    Article  CAS  PubMed  Google Scholar 

  40. Valiyil R, Casciola-Rosen L, Hong G, Mammen A, Christopher-Stine L (2010) Rituximab therapy for myopathy associated with anti-signal recognition particle antibodies: a case series. Arthritis Care Res 62(9):1328–1334

    Article  CAS  Google Scholar 

  41. Franceschini F, Cavazzana I, Generali D, Quinzanini M, Viardi L, Ghirardello A et al (2002) Anti-Ku antibodies in connective tissue diseases: clinical and serological evaluation of 14 patients. J Rheumatol 29(7):1393–1397

    PubMed  Google Scholar 

  42. Oddis CV, Okano Y, Rudert WA, Trucco M, Duquesnoy RJ, Medsger TAJ (1992) Serum autoantibodies to the nucleolar antigen PM-Scl. Clinical and immunogenetic associations. Arthritis Rheum 35:1211–1217

    Article  CAS  PubMed  Google Scholar 

  43. Tanimoto K, Nakano K, Kano S, Mori S, Ueki H, Nishitani H et al (1995) Classification criteria for polymyositis and dermatomyositis. J Rheumatol 22:668–674

    CAS  PubMed  Google Scholar 

  44. Targoff IN, Miller FW, Medsger TA Jr, Oddis CV (1997) Classification criteria for the idiopathic inflammatory myopathies. Curr Opin Rheumatol 9:527–535

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We acknowledge the Sanjay Gandhi Postgraduate Institute of Medical Sciences Intramural Research Grant Committee for funding current research (Intramural Grant No.: PGI/DIR/RC/306/2013).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ramnath Misra.

Ethics declarations

Conflict of interest

The authors declare they have no conflicts of interest.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional ethics committee and 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 32 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Srivastava, P., Dwivedi, S. & Misra, R. Myositis-specific and myositis-associated autoantibodies in Indian patients with inflammatory myositis. Rheumatol Int 36, 935–943 (2016). https://doi.org/10.1007/s00296-016-3494-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-016-3494-3

Keywords

Navigation