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Anti-Mi-2 antibodies characterize a distinct clinical subset of dermatomyositis with favourable prognosis

  • Clinical Report
  • Published:
European Journal of Dermatology

Abstract

Background

Anti-Mi-2 antibody is a type of myositis-specific autoantibody found in idiopathic inflammatory myopathy patients.

Objectives

To investigate the clinical features and long-term outcomes in anti-Mi-2-positive dermatomyositis (DM) patients.

Materials and Methods

Serum anti-Mi-2β antibodies were detected in 357 DM patients by enzyme-linked immunosorbent assays, and possible associated clinical features were investigated based on cross-sectional and longitudinal studies.

Results

Of the DM patients, 40/357 (11.2%) were positive for anti-Mi-2β antibodies and found to have a significantly higher frequency of V sign (72.5% vs 45.7%; p = 0.001), shawl sign (60.0% vs 35.6%; p = 0.003), and muscle weakness (77.5% vs 57.1%; p = 0.013), but a lower incidence of interstitial lung disease (ILD) (37.5% vs 60.9%; p = 0.005) and malignancy (0% vs 12.0%; p = 0.041) than anti-Mi-2β-negative patients. Anti-Mi-2β antibody levels positively correlated with disease activity. After a median follow-up period of 44 months, 97.0% of patients showed clinical remission. Twenty-six anti-Mi-2β-positive patients had a disease course longer than two years, and 16/26 (61.5%) were monocyclic without relapse. Moreover, five patients (15.1%) were drug-free with complete remission for more than three months. Kaplan-Meier survival curves showed that DM patients with positive anti-Mi-2β had a significantly lower mortality rate compared to anti-Mi-2β-negative patients (log-rank; p = 0.035). Interestingly, anti-Mi-2β antibodies did not disappear in all patients over time.

Conclusion

Anti-Mi-2β antibodies were associated with a subgroup of DM with a low frequency of ILD and malignancy, good treatment response, and favourable outcome. Moreover, anti-Mi-2β levels correlated with disease activity.

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Authors and Affiliations

  1. Department of Rheumatology, Beijing Key Lab for Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Yinghua East Road, Chaoyang District, Beijing, 100029, China

    Lin Liang, Ya-Mei Zhang, He Chen, Li-Fang Ye, Shan-Shan Li, Xin Lu, Guo-Chun Wang & Qing-Lin Peng

  2. Graduate School of Peking Union Medical College, Beijing, 100730, China

    Lin Liang & Guo-Chun Wang

Authors
  1. Lin Liang
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  2. Ya-Mei Zhang
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  3. He Chen
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  4. Li-Fang Ye
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  5. Shan-Shan Li
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  6. Xin Lu
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  7. Guo-Chun Wang
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  8. Qing-Lin Peng
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Corresponding authors

Correspondence to Guo-Chun Wang or Qing-Lin Peng.

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Disclosure

Financial support: This work was supported by the National Natural Science Foundation of China (grant numbers: 81701615, 81971531 and 81571603) and Beijing Municipal Science & Technology Commission (grant numbers: Z181100001718063 and Z171100001017208). Conflicts of interest: none.

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Liang, L., Zhang, YM., Chen, H. et al. Anti-Mi-2 antibodies characterize a distinct clinical subset of dermatomyositis with favourable prognosis. Eur J Dermatol 30, 151–158 (2020). https://doi.org/10.1684/ejd.2020.3750

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