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Myositis autoantibody profiles and their clinical associations in Greek patients with inflammatory myopathies

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Abstract

Myositis-specific (MSAs) or-associated autoantibodies (MAAs) have been linked to particular clinical phenotypes of idiopathic inflammatory myopathies (IIM) and appear to aid diagnosis. The objective of this study was to analyze the prevalence of MSAs and MAAs and their possible clinical associations in Greek IIM patients. This study comprised 95 IIM patients classified based on the 2017 EULAR/ACR classification criteria. All patients had MSAs and MAAs measured in their sera by line immunoblot assay. Dermatomyositis was the most prevalent IIM clinical subtype. MSAs were found in 44% of the patients, whereas MAAs in 23%. The most frequently detected MSA was anti-Jo-1 (22%), while the most frequently detected MAA was anti-Ro-52 (30%). The distributions of MSAs/MAAs did not differ between the five IIM subgroups, except for anti-Mi-2 which was only detected in dermatomyositis patients. Patients with at least one MSA and/or MAA positivity showed more frequently IIM characteristic skin rashes, while those presenting solely MAA positivity had more often puffy hands and Raynaud’s phenomenon. Anti-Jo1-positive patients presented more frequently lung disease, while anti-Ro52 positivity related to mechanic’s hands. Anti-Ro-52 and anti-Jo-1 strongly associated with one another. Prevalence of IIM subtypes and of MSAs/MAAs in our patients is in line with published reports in populations of similar geographic distribution. While MSA and/or MAA positivity did associate with particular clinical manifestations, it did not predict in our cohort specific IIM subgroup as defined by the latest EULAR/ACR classification criteria. Future studies are warranted to conclusively decide if these autoantibodies, measured with a standardized method, should or not be incorporated in every day clinical practice to aid IIM diagnosis.

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References

  1. Bohan A, Perter J, Peter JB (1975) Polymiositis and dermatomyositis (first of two parts). N Engl J Med 292:344–347. https://doi.org/10.1016/B978-012595961-2/50037-8

    Article  PubMed  CAS  Google Scholar 

  2. Bohan APJ (1975) Polymyositis and dermatomyositis (second of two parts). N Engl J Med 292:403–407. https://doi.org/10.1056/NEJM198109243051303

    Article  PubMed  CAS  Google Scholar 

  3. Dalakas MC (1991) Polymyositis, dermatomyositis and inclusion-body myositis. N Engl J Med 325:1487–1498

    Article  PubMed  CAS  Google Scholar 

  4. Dalakas MC, Hohlfeld R (2003) Polymyositis and dermatomyositis. Lancet 362:971–982. https://doi.org/10.1016/S0140-6736(03)14368-1

    Article  PubMed  CAS  Google Scholar 

  5. 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. https://doi.org/10.1097/01.md.0000173991.74008.b0

    Article  Google Scholar 

  6. Betteridge Z, McHugh N (2016) Myositis-specific autoantibodies: an important tool to support diagnosis of myositis. J Intern Med 280:8–23. https://doi.org/10.1111/joim.12451

    Article  PubMed  CAS  Google Scholar 

  7. Satoh M, Tanaka S, Ceribelli A, Calise SJ, Chan EKL (2017) A comprehensive overview on myositis-specific antibodies: new and old biomarkers in idiopathic inflammatory myopathy. Clin Rev Allergy Immunol 52:1–19. https://doi.org/10.1007/s12016-015-8510-y

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  8. Gunawardena H (2017) The clinical features of myositis-associated autoantibodies: a review. Clin Rev Allergy Immunol 52:45–57. https://doi.org/10.1007/s12016-015-8513-8

    Article  PubMed  CAS  Google Scholar 

  9. Brouwer R, Hengstman GJD, Vree Egberts W et al (2001) Autoantibody profiles in the sera of European patients with myositis. Ann Rheum Dis 60:116–123. https://doi.org/10.1136/ard.60.2.116

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Hengstman GJD, Van Venrooij WJ, Vencovsky J et al (2000) The relative prevalence of dermatomyositis and polymyositis in Europe exhibits a latitudinal gradient. Ann Rheum Dis 59:141–142. https://doi.org/10.1136/ard.59.2.141

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Lundberg IE, Tjärnlund A, Bottai M, Werth VP, Pilkington C, Visser M, Alfredsson L, Amato AA, Barohn RJ, Liang MH, Singh JA, Aggarwal R, Arnardottir S, Chinoy H, Cooper RG, Dankó K, Dimachkie MM, Feldman BM, Torre IGDL, Gordon P, Hayashi T, Katz JD, Kohsaka H, Lachenbruch PA, Lang BA, Li Y, Oddis CV, Olesinska M, Reed AM, Rutkowska-Sak L, Sanner H, Selva-O’Callaghan A, Song YW, Vencovsky J, Ytterberg SR, Miller FW, Rider LG (2017) 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis 76:1955–1964. https://doi.org/10.1136/annrheumdis-2017-211468

    Article  PubMed  PubMed Central  Google Scholar 

  12. Malaviya AN, Delhi N, Kunj V, et al (2017) 2017 EULAR/ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: little emphasis on autoantibodies, why? 2017 EULAR/ACR classification criteria for adult and juvenile idiopathic inflammator. 2017–2018. https://doi.org/10.1136/annrheumdis-2017-212701

  13. Ghirardello A, Rampudda M, Ekholm L, Bassi N, Tarricone E, Zampieri S, Zen M, Vattemi GA, Lundberg IE, Doria A (2010) Diagnostic performance and validation of autoantibody testing in myositis by a commercial line blot assay. Rheumatology 49:2370–2374. https://doi.org/10.1093/rheumatology/keq281

    Article  PubMed  CAS  Google Scholar 

  14. Rönnelid J, Barbasso S, Storfors H et al (2009) Use of a commercial line blot assay as a screening test for autoantibodies in inflammatory myopathies. Autoimmun Rev 9:58–61. https://doi.org/10.1016/j.autrev.2009.03.005

    Article  PubMed  CAS  Google Scholar 

  15. Vulsteke J-B, De Langhe E, Claeys KG, Dillaerts D, Poesen K, Lenaerts J, Westhovens R, Van Damme P, Blockmans D, De Haes P, Xavier B (2018) Detection of myositis-specific antibodies. 1–4. https://doi.org/10.1136/annrheumdis-2017-212915

  16. Lilleker JB, Vencovsky J, Wang G, et al (2018) The EuroMyositis registry: an international collaborative tool to facilitate myositis research. 30–39. https://doi.org/10.1136/annrheumdis-2017-211868

  17. Selva-O’Callaghan A, Labrador-Horrillo M, Solans-Laque R et al (2006) Myositis-specific and myositis-associated antibodies in a series of eighty-eight mediterranean patients with idiopathic inflammatory myopathy. Arthritis Care Res 55:791–798. https://doi.org/10.1002/art.22237

    Article  Google Scholar 

  18. Palterer B, Vitiello G, Carraresi A, Giudizi MG, Cammelli D, Parronchi P (2018) Bench to bedside review of myositis autoantibodies. Clin Mol Allergy 16:1–17. https://doi.org/10.1186/s12948-018-0084-9

    Article  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  20. Cruellas M, Viana V, 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 68:909–914. https://doi.org/10.6061/clinics/2013(07)04

    Article  PubMed  PubMed Central  Google Scholar 

  21. Picard C, Vincent T, Lega JC, Hue S, Fortenfant F, Lakomy D, Humbel RL, Goetz J, Molinari N, Bardin N, Bertin D, Johanet C, Chretien P, Dubucquoi S, Streichenberger N, Desplat-Jégo S, Bossuyt X, Sibilia J, Abreu I, Chevailler AFN (2016) Heterogeneous clinical spectrum of anti-SRP myositis and importance of the methods of detection of anti-SRP autoantibodies: a multicentric study. Immunol Res 64:677–686. https://doi.org/10.1007/s12026-015-8774-6

    Article  PubMed  CAS  Google Scholar 

  22. Fujimoto M, Hamaguchi Y, Kaji K et al (2012) Myositis-specific anti-155/140 autoantibodies target transcription intermediary factor 1 family proteins. 64:513–522. https://doi.org/10.1002/art.33403

  23. Sato S, Hoshino K, Satoh T et al (2009) RNA helicase encoded by melanoma differentiation – associated gene 5 is a major autoantigen in patients with clinically amyopathic dermatomyositis association with rapidly progressive interstitial lung disease. 60:2193–2200. https://doi.org/10.1002/art.24621

  24. Dankó K, Ponyi A, Molnar AP, András C, Constantin T (2009) Paraneoplastic myopathy. Curr Opin Rheumatol 21:594–598. https://doi.org/10.1097/BOR.0b013e3283317fa5

    Article  PubMed  Google Scholar 

  25. 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 1γ. Arthritis Rheum 65:2954–2962. https://doi.org/10.1002/art.38093

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  26. Ghillani P, André C, Toly C, Rouquette AM, Bengoufa D, Nicaise P, Goulvestre C, Gleizes A, Dragon-Durey MA, Alyanakian MA, Chretien P, Chollet-Martin S, Musset L, Weill B, Johanet C (2011) Clinical significance of anti-Ro52 (TRIM21) antibodies non-associated with anti-SSA 60 kDa antibodies: results of a multicentric study. Autoimmun Rev 10:509–513. https://doi.org/10.1016/j.autrev.2011.03.004

    Article  PubMed  CAS  Google Scholar 

  27. Satoh M, Chan EKL, Ho LA et al (2012) Prevalence and sociodemographic correlates of antinuclear antibodies in the United States. 64:2319–2327. https://doi.org/10.1002/art.34380

  28. Yamasaki Y, Satoh M, Mizushima M et al (2015) Clinical subsets associated with different anti- aminoacyl transfer RNA synthetase antibodies and their association with coexisting anti-Ro52. 7595. https://doi.org/10.3109/14397595.2015.1091155

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Funding

The study was supported by an uncommitted grant from the Institute for Autoimmune Systemic and Neurological Diseases.

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Correspondence to Evangelia Zampeli.

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The study was approved by the Ethical/Scientific Committee of the Athens Medical, School National and Kapodistrian University (1718024741-19/04/2018).

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Zampeli, E., Venetsanopoulou, A., Argyropoulou, O.D. et al. Myositis autoantibody profiles and their clinical associations in Greek patients with inflammatory myopathies. Clin Rheumatol 38, 125–132 (2019). https://doi.org/10.1007/s10067-018-4267-z

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  • DOI: https://doi.org/10.1007/s10067-018-4267-z

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