1
|
Joseph AJ, Dhakal B, Erla SR, Singh Y, Singh L, Upadhyay AD, Bagri NK, Lodha R, Kabra SK. Prevalence and Clinical Implications of Autoantibodies in Juvenile Dermatomyositis: A Single-Center Experience From India. J Clin Rheumatol 2024; 30:271-275. [PMID: 39167787 DOI: 10.1097/rhu.0000000000002127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
OBJECTIVE This study aimed to characterize the profile of myositis-specific and myositis-associated autoantibodies (MSAs/MAAs) in an Indian cohort of juvenile dermatomyositis (JDM) patients and correlate them with clinical features and outcomes. METHODS Forty-three children diagnosed with JDM were enrolled for this observational study. Clinical details (presentation, course, and outcome) were noted in a predesigned proforma. Serum samples were tested for 16 MSAs/MAAs by line immunoassay. MSAs/MAAs were correlated with clinical features and outcome (defined as a complete clinical response [≥6 months' disease inactivity on medication] or complete remission [≥6 months' inactivity off all drugs]). RESULTS Thirty-five subjects (81.4%) had at least 1 MSA/MAA detected. The most common antibodies were anti-NXP2 (n = 13, 30.2%), anti-TIF1γ (n = 10, 23.2%), and anti-MDA-5 (n = 8, 18.6%). No patient had anti-Ku, anti-Pm Scl-100, anti-PL-12, anti-EJ, anti-OJ, or anti-Ro52. Thirty-two patients (74.4%) attained a complete clinical response over a median follow-up duration of 14 months, among which 6 (13.9%) achieved complete remission over a median follow-up duration of 30 months. Anti-TIF1γ was associated with younger age at onset (≤3 years) (odds ratio [OR], 6.25; 95% confidence interval [CI], 1.15-34.12; p = 0.034) and disease flares after attaining complete response (OR, 10.18; 95% CI, 1.64-70.93; p = 0.013). Patients with anti-NXP2 had higher odds of severe muscular weakness (OR, 3.73; 95% CI, 0.95-14.59; p = 0.058) and truncal weakness (OR, 3.89; 95% CI, 0.97-15.64; p = 0.056). One child with anti-MDA-5 positivity had interstitial lung disease. We found no association between the MSA/MAA profile and the achievement of complete clinical response or remission. CONCLUSIONS MSAs/MAAs were identified in 81% of children with JDM in our study, which is higher than most other studies. The most frequently observed antibodies displayed a pattern consistent with other studies. Anti-TIF1γ was associated with a younger age at onset and disease flares even after attaining a complete clinical response. Anti-NXP2 had higher odds of severe muscular weakness. These observations suggest consistency in certain phenotypic associations observed across geographic boundaries.
Collapse
Affiliation(s)
| | | | | | | | | | - Ashish D Upadhyay
- Central Research Unit, All-India Institute of Medical Sciences, New Delhi, India
| | | | | | | |
Collapse
|
2
|
Houen G. Auto-immuno-deficiency syndromes. Autoimmun Rev 2024; 23:103610. [PMID: 39209011 DOI: 10.1016/j.autrev.2024.103610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/26/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
Autoimmune diseases constitute a broad, heterogenous group with many diverse and often overlapping symptoms. Even so, they are traditionally classified as either systemic, rheumatic diseases or organ-directed diseases. Several theories exist about autoimmune diseases, including defective self-recognition, altered self, molecular mimicry, bystander activation and epitope spreading. While there is no consensus about these theories, it is generally accepted that genetic, pre-disposing factors in combination with environmental factors can result in autoimmune disease. The relative contribution of genetic and environmental factors varies between diseases, as does the significance of individual contributing factors within related diseases. Among the genetic factors, molecules involved in antigen (Ag) recognition, processing, and presentation stand out (e.g., MHC I and II) together with molecules involved in immune signaling and regulation of cellular interactions (i.e., immuno-phenotypes). Also, various immuno-deficiencies have been linked to development of autoimmune diseases. Among the environmental factors, infections (e.g., viruses) have attracted most attention, but factors modulating the immune system have also been the subject of much research (e.g., sunlight and vitamin D). Multiple sclerosis currently stands out due to a very strong and proven association with Epstein-Barr virus infection, notably in cases of late infection and in cases of EBV-associated mononucleosis. Thus, a common picture is emerging that both systemic and organ-directed autoimmune diseases may appropriately be described as auto-immuno-deficiency syndromes (AIdeSs), a concept that emphasizes and integrates existing knowledge on the role of immuno-deficiencies and chronic infections with development of overlapping disease syndromes with variable frequencies of autoantibodies and/or autoreactive T cells. This review integrates and exemplifies current knowledge on the interplay of genetically determined immuno-phenotypes and chronic infections in the development of AIdeSs.
Collapse
Affiliation(s)
- Gunnar Houen
- Department of Neurology and Translational Research Center (TRACE), Rigshospitalet, Nordstjernevej 42, DK-2600 Glostrup, Denmark; Department of Biochemistry and Molecular Biology, University of Southern Denmark, DK-5230 Odense, Denmark.
| |
Collapse
|
3
|
Weng CT, Huang TH, Wu CH, Sun YT. Association of anti-Ro-52 antibodies with occurrence of interstitial lung disease in patients with idiopathic inflammatory myopathy. Arthritis Res Ther 2024; 26:152. [PMID: 39175076 PMCID: PMC11340136 DOI: 10.1186/s13075-024-03382-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 07/31/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Anti-Ro-52 antibodies have been associated with interstitial lung disease (ILD) in various autoimmune diseases. However, their role in ILD among patients with idiopathic inflammatory myopathies (IIMs) is relatively underexplored. This study aimed to investigate the association between anti-Ro-52 antibodies and the occurrence of ILD in individuals with IIMs. METHODS This retrospective observational study included 604 patients who underwent myositis autoantibody testing between July 2018 and January 2021 at our hospital and were diagnosed with either IIMs or IIM-mimics. Comparative analyses were conducted between IIMs and IIM-mimics, as well as within the IIM group between cases with and without ILD. Logistic regression or Firth's logistic regression analyses were employed to assess the risk of ILD development in different IIM subgroups and myositis antibody categories. RESULTS This study included 190 patients with IIM and 414 patients with IIM-mimics. Patients with IIM demonstrated higher incidence of ILD, concurrent autoimmune disease, and a greater likelihood of various myositis autoantibodies when compared to the IIM-mimics group. Within the IIM patient cohort, those with ILD exhibited a later age of onset of IIM, an increased mortality rate, and a more frequent presence of anti-aminoacyl-tRNA synthetase (ARS) antibodies compared to those without ILD. The presence of any myositis-specific antibody (MSA) was associated with a six-fold increased risk of ILD, while dual positivity for MSA and anti-Ro-52 antibodies conferred a twenty-fold risk. Anti-ARS antibodies carried a 14-fold increased risk of ILD, which escalated to 38-fold in cases of dual positivity for anti-ARS and anti-Ro-52 antibodies. Anti-Ro-52 antibodies alone increased the risk eight-fold. CONCLUSIONS Among patients with IIM, the presence of ILD was linked to higher mortality. Certain autoantibodies, notably anti-ARS and anti-Ro-52 antibodies, were associated with an increased risk of ILD. The greatest risk of ILD was observed in cases of dual positivity for anti-ARS and anti-Ro-52 antibodies.
Collapse
Affiliation(s)
- Chia-Tse Weng
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Sheng-Li Road, Tainan, 704, Taiwan
| | - Tang-Hsiu Huang
- Division of Chest Medicine, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Sheng-Li Road, Tainan, 704, Taiwan
| | - Chun-Hsin Wu
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Sheng-Li Road, Tainan, 704, Taiwan.
| | - Yuan-Ting Sun
- Department of Neurology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 1, University Road, Tainan, 701, Taiwan.
- Department of Medical Genomics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Sheng-Li Road, Tainan, 704, Taiwan.
| |
Collapse
|
4
|
Gong X, He S, Cai P. Roles of TRIM21/Ro52 in connective tissue disease-associated interstitial lung diseases. Front Immunol 2024; 15:1435525. [PMID: 39165359 PMCID: PMC11333224 DOI: 10.3389/fimmu.2024.1435525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/19/2024] [Indexed: 08/22/2024] Open
Abstract
Multiple factors contribute to the development of connective tissue diseases (CTD), often alongside a range of interstitial lung diseases (ILD), including Sjögren's syndrome-associated ILD, systemic sclerosis-associated ILD, systemic lupus erythematosus-associated ILD, idiopathic inflammatory myositis-associated ILD. TRIM21(or Ro52), an E3 ubiquitin ligase, plays a vital role in managing innate and adaptive immunity, and maintaining cellular homeostasis, and is a focal target for autoantibodies in various rheumatic autoimmune diseases. However, the effectiveness of anti-TRIM21 antibodies in diagnosing CTD remains a matter of debate because of their non-specific nature. Recent studies indicate that TRIM21 and its autoantibody are involved in the pathogenesis of CTD-ILD and play an important role in diagnosis and prognosis. In this review, we focus on the contribution of TRIM21 in the pathogenesis of CTD-ILD, as well as the potential diagnostic value of its autoantibodies in different types of CTD-ILD for disease progression and potential as a novel therapeutic target.
Collapse
Affiliation(s)
| | | | - Pengcheng Cai
- Department of Clinical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
5
|
Sabzwari SRA, Tzou WS. Systemic Diseases and Heart Block. Rheum Dis Clin North Am 2024; 50:381-408. [PMID: 38942576 DOI: 10.1016/j.rdc.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.
Collapse
Affiliation(s)
- Syed Rafay A Sabzwari
- University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Mail Stop B130, Aurora, CO 80045, USA
| | - Wendy S Tzou
- Cardiac Electrophysiology, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue, MS B-136, Aurora, CO 80045, USA.
| |
Collapse
|
6
|
Najjar R, Alessi H, Pinal-Fernandez I, Mammen AL, Mustelin T. Distinct Transcript-Level Expression Profiles and Unique Alternative Splicing in Inflammatory Myopathies. ACR Open Rheumatol 2024. [PMID: 39073022 DOI: 10.1002/acr2.11724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/18/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE The pathogenesis of inflammatory myopathies is poorly understood and there is a need to dissect the transcriptome in more granular ways beyond gene expression. METHODS We used a set of muscle RNA-sequencing data from different myositis subtypes grouped by their specific autoantibodies (n = 152). We quantified annotated RNA transcripts for each myositis subtype and identified uniquely expressed RNA as well as transcriptional similarities among myositis types. In addition, we quantified event-based alternative splicing with predicted protein changes. And finally, we searched for cryptic exons. RESULTS We saw considerable overlap in RNA expression among subtypes. In addition, MADCAM1 was previously shown to be uniquely expressed in Mi-2 myositis; we discovered it was two noncanonical transcripts that predominantly contributed to the observed increased expression. At the transcriptional level, dermatomyositis subtypes were least similar to inclusion body myositis (IBM) or Jo1, followed by HMGCR, then SRP and other dermatomyositis subtype. Additionally, we discovered many alternative splicing events that were unique by myositis subgroup, including events in muscle dystrophy genes and one event in SRP72, which was seen uniquely in SRP myositis. Finally, we looked for previously reported cryptic exons in IBM and did not find them. CONCLUSION The large degree of transcriptional overlap among myositis subtypes reinforces the need to use disease (in addition to healthy) controls to find unique features of autoimmune disease. Unique alterations in the transcriptome that are seen in one myositis subtype and not others advance our understanding of distinct disease pathology.
Collapse
Affiliation(s)
| | - Hugh Alessi
- University of Washington, Seattle, Washington
| | - Iago Pinal-Fernandez
- National Institute of Arthritis and Musculoskeletal and Skin Disease, National Institutes of Health, Bethesda, Maryland
| | - Andrew L Mammen
- National Institute of Arthritis and Musculoskeletal and Skin Disease, National Institutes of Health, Bethesda, Maryland
| | | |
Collapse
|
7
|
Martel ME, Leurs A, Launay D, Behal H, Chepy A, Collet A, Sanges S, Hachulla E, Dubucquoi S, Dauchet L, Sobanski V. Prevalence of anti-Ro52-kDa/SSA (TRIM21) antibodies and associated clinical phenotype in systemic sclerosis: Data from a French cohort, a systematic review and meta-analysis. Autoimmun Rev 2024; 23:103536. [PMID: 38555075 DOI: 10.1016/j.autrev.2024.103536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES Estimate the global prevalence of anti-Ro52-kDa/SSA (TRIM21) autoantibodies in systemic sclerosis (SSc), and describe the associated clinical phenotype, through a systematic review and meta-analysis of published reports and new data from our French cohort. METHODS Anti-TRIM21 seropositivity and associated SSc characteristics were assessed in a cross-sectional study including 300 patients of Lille University Hospital. A systematic review of the literature was performed in Pubmed and Embase, followed by a meta-analysis, using data on prevalence, clinical/demographical/biological characteristics of SSc patients and the type of assay used for anti-TRIM21 antibodies detection (PROSPERO n° CRD42021223719). FINDINGS In the cross-sectional study, anti-TRIM21 antibodies prevalence was 26% [95%CI: 21; 31]. Anti-centromere antibodies were the most frequent SSc specific autoantibodies coexisting with anti-TRIM21. Patients with anti-TRIM21 antibodies were more frequently women (91% vs 77%, p = 0.006), more likely to present an associated Sjögren's syndrome (19% vs 7%, p < 0.001), had a higher rate of pulmonary arterial hypertension (PAH) (15% vs 6%, p = 0.017) and a greater frequency of digestive complications such as dysphagia (12% vs 5%, p = 0.038) or nausea/vomiting (10% vs 3%, p = 0.009) than anti-TRIM21 negative patients. Thirty-five articles corresponding to a total of 11,751 SSc patients were included in the meta-analysis. In this population, the overall seroprevalence of anti-TRIM21 antibodies was 23% [95%CI: 21; 27] with a high degree of heterogeneity (I2: 93% Phet: <0.0001), partly explained by the methods of detection. Anti-TRIM21 seropositivity was positively associated with female sex (OR: 1.60 [95%CI: 1.25, 2.06]), limited cutaneous subset (OR: 1.29 [1.04, 1.61]), joint manifestations (OR: 1.33 [1.05, 1.68]), pulmonary hypertension (PH) (OR: 1.82 [1.42, 2.33]), and interstitial lung disease (ILD) (OR: 1.31 [1.07, 1.60]). INTERPRETATION Anti-TRIM21 antibodies frequently co-exist with usual SSc antibodies, but are independently associated to a higher risk of cardio-pulmonary complications. The presence of these autoantibodies should therefore be considered when assessing the risk of developing PH and ILD, and deserves further studies on appropriate screening and follow-up of patients.
Collapse
Affiliation(s)
- Marie-Elise Martel
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Amélie Leurs
- CH Dunkerque, Département de Médecine interne et Maladies infectieuses, F-59240 Dunkerque, France
| | - David Launay
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Hélène Behal
- CHU Lille, SEED: Statistique, évaluation, économique, data-management - Maison Régionale de la Recherche Clinique, F-59000 Lille, France
| | - Aurélien Chepy
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Aurore Collet
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Sébastien Sanges
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Eric Hachulla
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Sylvain Dubucquoi
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Luc Dauchet
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France
| | - Vincent Sobanski
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France; Institut Universitaire de France (IUF), Paris, France.
| |
Collapse
|
8
|
Benjelloun H, Haouassia FE, Chaanoune K, Zaghba N, Yassine N. Diffuse Interstitial Lung Disease Revealing Antisynthetase Syndrome. Cureus 2024; 16:e57513. [PMID: 38707080 PMCID: PMC11067390 DOI: 10.7759/cureus.57513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/07/2024] Open
Abstract
Interstitial lung disease (ILD) is a frequent manifestation of connective tissue diseases. They may be revelatory of the disease or occur during follow-up. Antisynthetase syndrome (ASS) is a complex and heterogeneous autoimmune disorder. Antisynthetase antibodies, in particular the anti-Jo-1 antibody, characterize this syndrome. The occurrence and severity of ILD determine the prognosis, which in turn determines therapeutic management. We report the case of a 53-year-old female patient presenting with ILD, revealing the diagnosis of ASS. The evolution was favorable with bolus corticosteroids associated with cyclophosphamide.
Collapse
Affiliation(s)
| | | | | | - Nahid Zaghba
- Pulmonary Medicine, Ibn Rochd University Hospital, Casablanca, MAR
| | - Najiba Yassine
- Pulmonology, Ibn Rochd University Hospital, Casablanca, MAR
| |
Collapse
|
9
|
Anang DC, Walter HAW, Lim J, Niewold ITG, van der Weele L, Aronica E, Eftimov F, Raaphorst J, van Schaik BDC, van Kampen AHC, van der Kooi AJ, de Vries N. TCRβ clones in muscle tissue share structural features in patients with idiopathic inflammatory myopathy and are associated with disease activity. Front Immunol 2024; 14:1279055. [PMID: 38268914 PMCID: PMC10806010 DOI: 10.3389/fimmu.2023.1279055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/13/2023] [Indexed: 01/26/2024] Open
Abstract
Objectives To characterize the T cell receptor (TCRβ) repertoire in peripheral blood and muscle tissues of treatment naïve patients with newly diagnosed idiopathic inflammatory myopathies (IIMs). Methods High throughput RNA sequencing of the TCRβ chain was performed in peripheral blood and muscle tissue in twenty newly-diagnosed treatment-naïve IIM patients (9 DM, 5 NM/OM, 5 IMNM and 1 ASyS) and healthy controls. Results thereof were correlated with markers of disease activity. Results Muscle tissue of IIM patients shows more expansion of TCRβ clones and decreased diversity when compared to peripheral blood of IIM as well as healthy controls (both p=0.0001). Several expanded TCRβ clones in muscle are tissue restricted and cannot be retrieved in peripheral blood. These clones have significantly longer CDR3 regions when compared to clones (also) found in circulation (p=0.0002), while their CDR3 region is more hydrophobic (p<0.01). Network analysis shows that clonal TCRβ signatures are shared between patients. Increased clonal expansion in muscle tissue is significantly correlated with increased CK levels (p=0.03), while it tends to correlate with decreased muscle strength (p=0.08). Conclusion Network analysis of clones in muscle of IIM patients shows shared clusters of sequences across patients. Muscle-restricted CDR3 TCRβ clones show specific structural features in their T cell receptor. Our results indicate that clonal TCRβ expansion in muscle tissue might be associated with disease activity. Collectively, these findings support a role for specific clonal T cell responses in muscle tissue in the pathogenesis of the IIM subtypes studied.
Collapse
Affiliation(s)
- Dornatien C. Anang
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Genome Analysis, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Hannah A. W. Walter
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Johan Lim
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Ilse T. G. Niewold
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Genome Analysis, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Linda van der Weele
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Eleonora Aronica
- Department of (Neuro) Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Filip Eftimov
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Joost Raaphorst
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Barbera D. C. van Schaik
- Bioinformatics Laboratory, Department of Epidemiology and Data Science, Amsterdam Public Health Institute, Amsterdam Infection and Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Antoine H. C. van Kampen
- Bioinformatics Laboratory, Department of Epidemiology and Data Science, Amsterdam Public Health Institute, Amsterdam Infection and Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Anneke J. van der Kooi
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Niek de Vries
- Department of Rheumatology and Clinical Immunology, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Department of Experimental Immunology, Amsterdam Infection and Immunity Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
10
|
Yoshida A, Nagata S, Okazaki Y, Hanaoka H, Gono T, Kuwana M. Dissociating Autoantibody Responses against Ro52 Antigen in Patients with Anti-Synthetase or Anti-MDA5 Antibodies. Diagnostics (Basel) 2023; 13:3621. [PMID: 38132205 PMCID: PMC10742448 DOI: 10.3390/diagnostics13243621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/27/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
We aimed to dissociate the autoantibody response against the Ro52 protein in patients with anti-synthetase or anti-melanoma differentiation-associated gene 5 (MDA5) antibodies to explore the potential roles of different anti-Ro52 autoantibody responses in disease subclassification. This study used a single-center, prospective myositis cohort involving 122 consecutive patients with anti-synthetase antibodies identified by RNA immunoprecipitation (RNA-IP) and 34 patients with anti-MDA5 antibodies detected using enzyme immunoassay (EIA). Anti-Ro52 antibodies were measured using commercial EIA kits, while anti-Ro/SSA antibodies were identified using RNA-IP. Clinical features and outcomes were stratified according to two different patterns of autoantibody responses against Ro52, including "isolated anti-Ro52", defined by positive anti-Ro52 and negative anti-Ro/SSA antibodies, and "anti-SSA-Ro52", defined by positive anti-Ro52 and anti-Ro/SSA antibodies. Isolated anti-Ro52 positivity was the most prevalent autoantibody response in patients with both anti-synthetase (40/122; 32.8%) and anti-MDA5 antibodies (8/34; 23.5%). Isolated anti-Ro52 or anti-SSA-Ro52 positivity was associated with Gottron's sign in patients with anti-synthetase antibodies, while in patients with anti-MDA5 antibodies, isolated anti-Ro52 positivity was associated with respiratory insufficiency at initial presentation and poor overall survival. Isolated anti-Ro52 positivity could be a potential biomarker for patient stratification; however, the clinical significance of dissociating isolated anti-Ro52 positivity from overall anti-Ro52 positivity was not evident.
Collapse
Affiliation(s)
- Akira Yoshida
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo 113-8602, Japan; (Y.O.); (T.G.)
| | - Shunya Nagata
- School of Medicine, Nippon Medical School, Tokyo 113-8602, Japan;
| | - Yuka Okazaki
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo 113-8602, Japan; (Y.O.); (T.G.)
| | - Hironari Hanaoka
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan;
| | - Takahisa Gono
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo 113-8602, Japan; (Y.O.); (T.G.)
- Scleroderma/Myositis Center of Excellence, Nippon Medical School Hospital, Tokyo 113-8603, Japan
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo 113-8602, Japan; (Y.O.); (T.G.)
- Scleroderma/Myositis Center of Excellence, Nippon Medical School Hospital, Tokyo 113-8603, Japan
| |
Collapse
|
11
|
Holwek E, Opinc-Rosiak A, Sarnik J, Makowska J. Ro52/TRIM21 - From host defense to autoimmunity. Cell Immunol 2023; 393-394:104776. [PMID: 37857191 DOI: 10.1016/j.cellimm.2023.104776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/05/2023] [Accepted: 10/14/2023] [Indexed: 10/21/2023]
Abstract
Ro52 (TRIM21) belongs to the ubiquitin ligase family. This protein plays a crucial role in many immunological processes, including antibody-dependent intracellular neutralization, synergy with the complement system, antiviral response, death mediation, oxidative stress response, and protein ubiquitination. Abnormal expression of TRIM21 can break immunological tolerance and lead to the production of autoantibodies against TRIM21. Antibodies against TRIM21 are detected in various autoimmune diseases, including Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), or myositis. However, anti-TRIM21 presence is not limited to autoimmune connective tissue disorders. It was observed in patients with malignancies, various cancerous processes, infectious diseases, and idiopathic interstitial pneumonia. The occurrence of TRIM21 autoantibodies is also associated with clinical features, such as the prevalence of interstitial lung diseases and cardiac or haematological involvement in connective tissue disorders. The purpose of this review was to summarize current knowledge of the immunological functions of TRIM21 and analyze the clinical implications of anti-TRIM21 antibodies in the disease course.
Collapse
Affiliation(s)
- Emilia Holwek
- Laboratory of Transplantation Immunology, Independent Public Healthcare Centre, Central Clinical Hospital of Medical University of Lodz, Lodz 92-213, Poland
| | | | - Joanna Sarnik
- Department of Rheumatology, Medical University of Lodz, Lodz 92-115, Poland
| | - Joanna Makowska
- Department of Rheumatology, Medical University of Lodz, Lodz 92-115, Poland.
| |
Collapse
|
12
|
Opinc-Rosiak AH, Makowska JS. Environmental exposures as risk factors for idiopathic inflammatory myopathies. J Autoimmun 2023; 140:103095. [PMID: 37797402 DOI: 10.1016/j.jaut.2023.103095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/25/2023] [Indexed: 10/07/2023]
Abstract
Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of rare autoimmune diseases, with increasing incidence rates observed in the recent years. The pathogenesis of IIM remains not fully understood, and the interaction of genetic and environmental factors is suspected. It is unclear whether the observed upward trend in the IIM incidence is solely due to improved access to effective diagnostics or perhaps due to increased exposure to external risk factors. The PUBMED database was thoroughly searched for articles describing environmental exposures potentially triggering the onset of IIM. The article summarizes the current knowledge available on this subject, taking into account various environmental factors, including among others UV radiation, infectious agents with SARS-CoV-2, inhaled particles, or iatrogenic effects. Limitations and unmet needs requiring further studies were highlighted.
Collapse
Affiliation(s)
| | - Joanna S Makowska
- Department of Rheumatology, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland.
| |
Collapse
|
13
|
Azzam M, Awad A, Abugharbyeh A, Kahaleh B. Myocarditis in connective tissue diseases: an often-overlooked clinical manifestation. Rheumatol Int 2023; 43:1983-1992. [PMID: 37587233 DOI: 10.1007/s00296-023-05428-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023]
Abstract
To discuss what is currently known about myocarditis in the context of major connective tissue diseases, including Systemic lupus erythematosus, Rheumatoid Arthritis, Sjogren, Dermato-myositis and Polymyositis, Systemic Sclerosis, and Mixed connective tissue disease. Variability exists between studies regarding the incidence of myocarditis in connective tissue diseases, which is hypothesized to be the result of its subclinical course in most cases. Extensive gaps of knowledge exist in the field of pathophysiology. Although endomyocardial biopsy remains to be the gold standard for diagnosis, the advancement in non-invasive modalities such as cardiac MRI, echocardiography, and nuclear medicine has allowed for earlier and more frequent detection of myocarditis. A lack of treatment guidelines was found across the different connective tissue diseases. Most of the literature available revolved around myocarditis in the context of Systemic lupus erythematosus. Numerous recent studies were published that contributed to advancements in diagnosis and treatment however, there remains a lack of diagnostic and treatment guidelines.
Collapse
Affiliation(s)
- Muayad Azzam
- Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan.
| | - Amro Awad
- Faculty of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Aya Abugharbyeh
- Division of Rheumatology and Immunology, University of Toledo Medical Center, Toledo, USA
| | - Bashar Kahaleh
- Division of Rheumatology and Immunology, University of Toledo Medical Center, Toledo, USA
| |
Collapse
|
14
|
Pepper E, Vilar L, Ward IM. Clinical Characteristics and Prognostic Value of Ro52/SSA Antibodies in Idiopathic Inflammatory Myopathies. J Clin Rheumatol 2023; 29:347-353. [PMID: 37748434 DOI: 10.1097/rhu.0000000000002015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
BACKGROUND/PURPOSE Anti-Ro52 are myositis-associated antibodies found in idiopathic inflammatory myopathies (IIMs). This chart review aims to evaluate the frequency, significance, and associated clinical characteristics of Ro52/SSA positivity in IIM patients. METHODS We performed a chart review of IIM patients diagnosed between January 2006 and December 2020. All patients met either the 1975 Bohan and Peter or the European League Against Rheumatism/American College of Rheumatology classification criteria for probable or definite myositis. Demographics, clinical and serologic parameters, treatments, and outcomes were compared in patients with anti-Ro52/SSA antibodies and patients without anti-Ro52/SSA antibodies. RESULTS One hundred eighty-nine patients with IIM were tested for either Ro52 or SSA, with 45 positive for Ro52/SSA (23.8%). Patients with IIM and Ro52/SSA+ were younger at age at onset of disease (44.8 vs. 51.2 years, p = 0.008). Ro52/SSA+ was more common in antisynthetase syndrome (p < 0.001; odds ratio [OR], 4.44; 95% confidence interval [CI], 2.11-9.33) and not frequently identified in clinically amyopathic dermatomyositis (CADM) (p = 0.02; OR, 0.13; 95% CI, 0.02-0.96) or immune-mediated necrotizing myopathy (p = 0.003; OR, 0.14; 95% CI, 0.03-0.63). Of the extraskeletal muscle manifestations, interstitial lung disease (ILD) was strongly associated with Ro52/SSA+ (p < 0.001; OR, 6.61; 95% CI, 3.15-13.86), as was dysphagia (p = 0.006; OR, 2.73; 95% CI, 1.31-5.71). Interstitial lung disease pattern and pulmonary function testing impairment did not differ based on antibody status. There was no significant difference in outcomes between groups. CONCLUSION In this myositis cohort, Ro52/SSA+ was present in nearly one-fourth of the population and had a strong association with the antisynthetase syndrome subtype, ILD, and dysphagia. Although these disease manifestations are associated with significant morbidity, in our cohort, they were not associated with increased mortality or more severe ILD.
Collapse
Affiliation(s)
- Elizabeth Pepper
- From the Department of Medicine, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA
| | - Lilian Vilar
- Rheumatology Service, Walter Reed National Military Medical Center, Bethesda, MD
| | - Ian M Ward
- Rheumatology Service, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA
| |
Collapse
|
15
|
Sabzwari SRA, Tzou WS. Systemic Diseases and Heart Block. Cardiol Clin 2023; 41:429-448. [PMID: 37321693 DOI: 10.1016/j.ccl.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.
Collapse
Affiliation(s)
- Syed Rafay A Sabzwari
- University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, Mail Stop B130, Aurora, CO 80045, USA
| | - Wendy S Tzou
- Cardiac Electrophysiology, University of Colorado Anschutz Medical Campus, 12401 E 17th Avenue, MS B-136, Aurora, CO 80045, USA.
| |
Collapse
|
16
|
Honda M, Shimizu F, Sato R, Mizukami Y, Watanabe K, Takeshita Y, Maeda T, Koga M, Kanda T. Jo-1 Antibodies From Myositis Induce Complement-Dependent Cytotoxicity and TREM-1 Upregulation in Muscle Endothelial Cells. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2023; 10:10/4/e200116. [PMID: 37147138 PMCID: PMC10162704 DOI: 10.1212/nxi.0000000000200116] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/21/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Muscle microangiopathy due to dysfunction of endothelial cells because of inflammation is a critical hallmark of dermatomyositis (DM); however, its pathomechanism remains unclear. The aim of this study was to evaluate the effect of immunogloblin G (IgG) from patients with idiopathic inflammatory myopathies (IIM) on muscle endothelial cells in vitro. METHODS Using a high-content imaging system, we analyzed whether IgG purified from sera from patients with IIM (n = 15), disease controls (DCs: n = 7), and healthy controls (HCs: n = 7) can bind to muscle endothelial cells and induce complement-dependent cellular cytotoxicity. RESULTS IgGs from Jo-1 antibody myositis could bind to muscle endothelial cells and caused complement-dependent cell cytotoxicity. RNA-seq demonstrated the upregulation of genes associated with tumor necrosis factor (TNF)-α, triggering receptor expressed on myeloid cells-1 (TREM-1), CD25, and mitochondria pathways after exposure to IgG from the Jo-1, signal recognition particle (SRP), and polymyositis (PM) groups. The high-content imaging system showed that TREM-1 expression in the Jo-1, SRP, and PM groups was increased in comparison with DCs and HCs and that the TNF-α expression in the Jo-1 group was higher in comparison with the SRP, PM, DC, and HC groups. The expression of TREM-1 was observed in biopsied capillaries and the muscle membrane from patients with Jo-1 and in biopsied muscle fiber and capillaries from patients with DM and SRP. The depletion of Jo-1 antibodies by IgG of patients with Jo-1 antibody myositis reduced the Jo-1 antibody-induced complement-dependent cellular cytotoxicity in muscle endothelial cells. DISCUSSION Jo-1 antibodies from Jo-1 antibody myositis show complement-dependent cellular cytotoxicity in muscle endothelial cells. IgGs from patients with Jo-1, SRP, and DM increase the TREM-1 expression in endothelial cells and muscles.
Collapse
Affiliation(s)
- Masaya Honda
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan
| | - Fumitaka Shimizu
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan.
| | - Ryota Sato
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan
| | - Yoichi Mizukami
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan
| | - Kenji Watanabe
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan
| | - Yukio Takeshita
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan
| | - Toshihiko Maeda
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan
| | - Michiaki Koga
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan
| | - Takashi Kanda
- From the Department of Neurology and Clinical Neuroscience (M.H., F.S., R.S., Y.T., M.K., T.K.), Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi; and Center for Gene Research (Y.M., K.W.), Yamaguchi University, Ube, Japan
| |
Collapse
|
17
|
Skarlis C, Michalakeas N, Gerochristou M, Raftopoulou S, Marketos N, Boki K, Vassilopoulos D, Stratigos AP, Boumpas D, Mavragani C. The Role of Myositis-Specific and Myositis-Associated Autoantibodies and the Activation of Type I Interferon Pathway in the Generation of Clinical Phenotypes of Inflammatory Myopathies. Mediterr J Rheumatol 2023; 34:275-278. [PMID: 37654645 PMCID: PMC10466366 DOI: 10.31138/mjr.34.2.275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/14/2022] [Indexed: 09/02/2023] Open
Abstract
Idiopathic inflammatory myopathies (IIMs) are a group of heterogeneous autoimmune diseases with a prevalence of 20 cases per 100000 of population. Despite their diversity, IMMs are characterised by several common clinical features such as muscle inflammation, proximal muscle weakness, abnormal electromyography and/or muscle biopsy. Over the last years, it has been increasingly recognised that an array of autoantibodies known as myositis-specific antibodies (MSAs) and myositis-associated antibodies (MAAs) are associated with distinct clinical phenotypes and diverse prognosis. Although the exact underlying mechanism of IIMs is not fully understood, accumulating data suggest that the activation of type I interferon pathway plays a central role in disease development. Previous studies have reported the upregulation of type I interferon (IFN) induced genes in peripheral blood and muscle biopsies derived from myositis patients. Given the heterogeneity of inflammatory myopathies along with the central role of type I IFN pathway in disease pathogenesis, the aim of the current study is to elucidate the link between distinct clinical phenotypes of inflammatory myopathies with the presence of serum MSAs or MAAs, as well as with type I IFN activation.
Collapse
Affiliation(s)
- Charalampos Skarlis
- Department of Physiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Michalakeas
- Department of Physiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Gerochristou
- Department of Physiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- First Department of Dermatology and Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Sylvia Raftopoulou
- Department of Physiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Marketos
- Department of Physiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Dimitrios Vassilopoulos
- Clinical Immunology-Rheumatology, Hippokration General Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, Athens, Greece
| | | | - Dimitrios Boumpas
- Joint Academic Rheumatology Program, Athens, Greece
- Fourth Department of Internal Medicine, University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| | - Clio Mavragani
- Department of Physiology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Joint Academic Rheumatology Program, Athens, Greece
- Fourth Department of Internal Medicine, University Hospital Attikon, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
18
|
Hallowell RW, Danoff SK. Diagnosis and Management of Myositis-Associated Lung Disease. Chest 2023; 163:1476-1491. [PMID: 36764512 DOI: 10.1016/j.chest.2023.01.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/04/2023] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Although interstitial lung disease (ILD) is a leading cause of morbidity and mortality in patients with inflammatory myopathies, the current definition and diagnostic criteria of autoimmune myositis remain inadequate to capture the large proportion of patients with lung-dominant disease. As a result, these patients present unique diagnostic and treatment challenges for even the most experienced clinicians. This article highlights the emerging role of autoantibodies in the diagnosis, classification, and management of patients with ILD. We propose alternative nomenclature to facilitate research on this unique patient population. Additionally, evidence supporting the various therapies used in the treatment of myositis-associated ILD is reviewed. The classification and treatment of patients with myositis-associated ILD remains challenging. A standardized therapeutic approach to these patients is lacking, and prospective studies in the field are needed to determine optimal treatment regimens.
Collapse
Affiliation(s)
- Robert W Hallowell
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Sonye K Danoff
- Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
| |
Collapse
|
19
|
Harsini S, Rezaei N. Autoimmune diseases. Clin Immunol 2023. [DOI: 10.1016/b978-0-12-818006-8.00001-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
20
|
Babu AK, Mizaj Z, Thomas J, Chacko M. Clinical Significance of Myositis-Specific and Myositis-Associated Antibody Profiles in Dermatomyositis. Indian Dermatol Online J 2022; 14:55-60. [PMID: 36776194 PMCID: PMC9910546 DOI: 10.4103/idoj.idoj_188_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/04/2022] [Accepted: 08/14/2022] [Indexed: 12/30/2022] Open
Abstract
Background Myositis-specific autoantibodies (MSA) and myositis-associated autoantibodies (MAA) are clinically useful biomarkers that point to the diagnosis, clinical manifestations, and prognosis of dermatomyositis (DM). Materials and Methods To estimate the prevalence of MSA as well as MAA and analyze possible clinical correlations of these autoantibodies in patients diagnosed with DM, we conducted a cross-sectional study of 30 patients who were diagnosed with DM. Results MSA were positive in 19 patients (63%) in which Mi 2 was positive in 8 (27%) patients, and this was the most frequently found MSA. A total of 11 (36.7%) patients showed positive MAA. AntiPM/Scl 75 and anti-Ro 52 were positive in 5 (16.7%) patients each and these were the most commonly found MAA. Anti-La was absent in all our patients. There were 8 (27%) patients in whom both MSA and MAA were positive. Either MSA and/or MAA were positive in 22 (73%) patients. On a bivariate analysis, the patients who were positive for anti-PM/Scl 75 showed a significant difference in manifesting cutaneous ulcers (P value 0.023). It was also found that anti-SAE-positive patients showed a significant difference with malignancy (P value 0.014). Anti-Ro 52-positive patients were less likely to have symmetrical proximal muscle weakness (P value 0.006). Conclusions All patients who were anti-MDA 5 positive had myositis and none of the anti-MDA 5-positive patients had rapidly progressive interstitial lung disease (RPILD). More than one MSA in the same patient was noted in three patients.
Collapse
Affiliation(s)
- Anuradha K. Babu
- Department of Dermatology, Aster Medcity, Kochi, Kerala, India,Address for correspondence: Dr. Anuradha K. Babu, Department of Dermatology, Aster Medcity, Kochi - 682 027, Kerala, India. E-mail:
| | - Z Mizaj
- Department of Dermatology, Aster Medcity, Kochi, Kerala, India
| | - Joe Thomas
- Department of Rheumatology, Aster Medcity, Kochi, Kerala, India
| | - Manas Chacko
- Department of Clinical Research, Aster Medcity, Kochi, Kerala, India
| |
Collapse
|
21
|
Zhen C, Hou Y, Zhao B, Ma X, Dai T, Yan C. Efficacy and safety of rituximab treatment in patients with idiopathic inflammatory myopathies: A systematic review and meta-analysis. Front Immunol 2022; 13:1051609. [PMID: 36578492 PMCID: PMC9791086 DOI: 10.3389/fimmu.2022.1051609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/16/2022] [Indexed: 12/14/2022] Open
Abstract
Objective Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of autoimmune diseases with various subtypes, myositis-specific antibodies, and affect multiple systems. The treatment of IIMs remains challenging, especially for refractory myositis. In addition to steroids and traditional immunosuppressants, rituximab (RTX), a B cell-depleting monoclonal antibody, is emerging as an alternative treatment for refractory myositis. However, the therapeutic response to RTX remains controversial. This meta-analysis aimed to systematically evaluate the efficacy and safety of RTX in patients with IIMs, excluding sporadic inclusion body myositis. Methods PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and WanFang Data were searched for relevant studies. The overall effective rate, complete response rate, and partial response rate were calculated to assess the efficacy of RTX. The incidences of adverse events, infection, severe adverse events, severe infection, and infusion reactions were collected to evaluate the safety of RTX. Subgroup analyses were performed using IIM subtypes, affected organs, continents, and countries. We also performed a sensitivity analysis to identify the sources of heterogeneity. Results A total of 26 studies were included in the quantitative analysis, which showed that 65% (95% confidence interval [CI]: 54%, 75%) of patients with IIMs responded to RTX, 45% (95% CI: 22%, 70%) of patients achieved a complete response, and 39% (95% CI: 26%, 53%) achieved a partial response. Subgroup analyses indicated that the overall efficacy rates in patients with refractory IIMs, dermatomyositis and polymyositis, as well as anti-synthetase syndrome were 62%, 68%, and 62%, respectively. The overall efficacy rates for muscle, lungs, and skin involvement were 59%, 65%, and 81%, respectively. In addition, studies conducted in Germany and the United States showed that patients with IIMs had an excellent response to RTX, with an effective rate of 90% and 77%, respectively. The incidence of severe adverse events and infections was 8% and 2%, respectively. Conclusion RTX may be an effective and relatively safe treatment choice in patients with IIMs, especially for refractory cases. However, further verification via randomized controlled trials is warranted.
Collapse
Affiliation(s)
- Chao Zhen
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China,Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, Qingdao, China
| | - Ying Hou
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Bing Zhao
- Department of Neurology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Xiaotian Ma
- Department of Medicine Experimental Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Tingjun Dai
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China,*Correspondence: Tingjun Dai, ; Chuanzhu Yan,
| | - Chuanzhu Yan
- Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China,Department of Central Laboratory and Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China,Brain Science Research Institute, Shandong University, Jinan, China,*Correspondence: Tingjun Dai, ; Chuanzhu Yan,
| |
Collapse
|
22
|
Kayser C, Dutra LA, Dos Reis-Neto ET, Castro CHDM, Fritzler MJ, Andrade LEC. The Role of Autoantibody Testing in Modern Personalized Medicine. Clin Rev Allergy Immunol 2022; 63:251-288. [PMID: 35244870 DOI: 10.1007/s12016-021-08918-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2021] [Indexed: 02/08/2023]
Abstract
Personalized medicine (PM) aims individualized approach to prevention, diagnosis, and treatment. Precision Medicine applies the paradigm of PM by defining groups of individuals with akin characteristics. Often the two terms have been used interchangeably. The quest for PM has been advancing for centuries as traditional nosology classification defines groups of clinical conditions with relatively similar prognoses and treatment options. However, any individual is characterized by a unique set of multiple characteristics and therefore the achievement of PM implies the determination of myriad demographic, epidemiological, clinical, laboratory, and imaging parameters. The accelerated identification of numerous biological variables associated with diverse health conditions contributes to the fulfillment of one of the pre-requisites for PM. The advent of multiplex analytical platforms contributes to the determination of thousands of biological parameters using minute amounts of serum or other biological matrixes. Finally, big data analysis and machine learning contribute to the processing and integration of the multiplexed data at the individual level, allowing for the personalized definition of susceptibility, diagnosis, prognosis, prevention, and treatment. Autoantibodies are traditional biomarkers for autoimmune diseases and can contribute to PM in many aspects, including identification of individuals at risk, early diagnosis, disease sub-phenotyping, definition of prognosis, and treatment, as well as monitoring disease activity. Herein we address how autoantibodies can promote PM in autoimmune diseases using the examples of systemic lupus erythematosus, antiphospholipid syndrome, rheumatoid arthritis, Sjögren syndrome, systemic sclerosis, idiopathic inflammatory myopathies, autoimmune hepatitis, primary biliary cholangitis, and autoimmune neurologic diseases.
Collapse
Affiliation(s)
- Cristiane Kayser
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | | | - Marvin J Fritzler
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Luis Eduardo C Andrade
- Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil. .,Immunology Division, Fleury Medicine and Health Laboratories, São Paulo, Brazil.
| |
Collapse
|
23
|
Chan EKL. Anti-Ro52 Autoantibody Is Common in Systemic Autoimmune Rheumatic Diseases and Correlating with Worse Outcome when Associated with interstitial lung disease in Systemic Sclerosis and Autoimmune Myositis. Clin Rev Allergy Immunol 2022; 63:178-193. [PMID: 35040083 DOI: 10.1007/s12016-021-08911-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 01/13/2023]
Abstract
This review highlights the 30 plus years research progress since the discovery of autoantibody to Ro52/TRIM21 in patients with systemic lupus erythematosus (SLE) and Sjögren's syndrome (SjS). After the initial expression cloning of the Ro52 cDNA, it has taken many years to the current understanding in the interesting biological function of Ro52 as an E3 ubiquitin ligase and its role in innate immune clearance of intracellular IgG-bound complex. Early observations show that anti-Ro52, mostly associated with anti-SS-A/Ro60 and/or anti-SS-B/La, is commonly found in SLE (40-70%), SjS (70-90%), neonatal lupus erythematosus (NLE, 75-90%), and subacute cutaneous lupus erythematosus (50-60%). Anti-Ro52 has long been postulated to play a direct pathogenic role in congenital heart block in NLE as well as in the QT interval prolongation in some adults. The widespread availability of the anti-Ro52 assay has led to the detection of anti-Ro52 in other diseases including autoimmune hepatitis (20-40%), systemic sclerosis (10-30%), and autoimmune myositis (20-40%). More than ten studies have pointed to an association of anti-Ro52 with interstitial lung disease and, more importantly, correlating with poor outcome and worse survival. Other studies are implicating an interesting role for anti-Ro52 in the diagnosis of certain cancers. Future studies are needed to examine the mechanism in the pathogenesis of anti-Ro52 and carefully documenting its causal relationships in different disease conditions.
Collapse
Affiliation(s)
- Edward K L Chan
- Department of Oral Biology, University of Florida, 1395 Center Drive, Gainesville, FL, 32610-0424, USA.
| |
Collapse
|
24
|
Nephrotic Syndrome as an Extramuscular Manifestation of Anti-EJ Antibody-Positive Dermatomyositis: A Case Report and Review of the Literature. Case Rep Rheumatol 2022; 2022:1233522. [PMID: 36249573 PMCID: PMC9553724 DOI: 10.1155/2022/1233522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/20/2022] [Indexed: 11/18/2022] Open
Abstract
Renal involvement is underestimated as an extramuscular manifestation of dermatomyositis (DM). Here, we describe a 67-year-old woman with anti-glycyl-transfer ribonucleic acid synthetase (anti-EJ) antibody and anti-ribonucleoprotein antibody-positive DM complicated by systemic sclerosis, who developed nephrotic syndrome concurrently with the exacerbation of DM, as indicated by incremental serum creatine kinase levels, high-intensity lesions on muscle magnetic resonance imaging, and active interstitial pneumonitis on chest computed tomography. Renal biopsy revealed the presence of immune-deposition in the glomerulus by immunofluorescence. To our knowledge, this is the first report describing the coexistence of anti-EJ antibody-positive DM and nephrotic syndrome. More reports of similar cases are warranted to substantiate the association.
Collapse
|
25
|
Hormaza-Jaramillo A, Bedoya-Joaqui V, Puerta-Sarmiento G, Bautista M, Rios-Serna LJ, Delgado-Mora T, Nieto-Aristizábal I, Ruiz-Ordoñez I. Profile of specific and associated autoantibodies in patients with idiopathic inflammatory myopathies in a Colombian population. Front Med (Lausanne) 2022; 9:954937. [PMID: 36045923 PMCID: PMC9420838 DOI: 10.3389/fmed.2022.954937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/22/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Idiopathic inflammatory myopathies (IIMs) are chronic, autoimmune diseases with several forms of presentation. Diagnosis is mostly clinical in our region. Our aim was to evaluate the autoantibody profile of patients with IIMs. Methods This study is a cross-sectional study with a prospective recollection of data, conducted between 2019–2021, in a single center in Cali, Colombia. Patients with a clinical diagnosis or suspicion of IIM were included. The presence of myositis-specific/associated antibodies was evaluated by immunoblotting in serum samples. Phenotypic characterization was performed. Results A total of 36 patients were included. The mean age was 50.6 (16.7) years, and 20 (55.6%) were female. Eighteen (50%) patients were seropositive, of which 11 (30.5%) presented one positive antibody, with anti-TIF1ɣbeing the most frequent (n = 4, 11.1%), followed by anti-Ro52 (n = 2, 5.6%). Seven patients (19.4%) showed >1 positive antibody. Dermatomyositis was the most frequent type of IIM in seropositive patients (n = 8, 44.4%), followed by anti-synthetase syndrome (n = 4, 22.2%). Weakness was symmetric and presented in the upper and lower extremities in 11 (61.1%) patients each. Both respiratory insufficiency and weight loss were seen in 7 (38.9%) patients, Gottron papules in six (33.3%) patients, and heliotrope rash, esophageal dysmotility, and myalgia in 5 (27.8%) patients. Pulmonary interstitial disease was seen in 4 (22.2%, with antibodies for anti-Ro52, anti-MDA5 + anti-Jo1 + anti-TIF1ɣ, anti-MDA5 + anti-SAE1 + anti-NXP2, and anti-cN1A + anti-Ro52) patients, and malignancy was seen in 2 (11.1%) patients (1 with anti-Mi2β and 1 with anti-TIF1ɣ + anti-Mi2α). In all, 7 (19.4%) patients required intensive care (2 seropositive, 1 with anti-PL7, 1 with anti-MDA5 + anti-Jo1 + anti-TIF1ɣ), and 1 (2.8%) (seronegative) patient died. Conclusion This study is the first study in the Southwest of Colombia that evaluates myositis-specific/associated antibodies in IIM. Half of the patients were seropositive. Anti-TIF1ɣwas the most frequent MSA and anti-Ro52 was the most frequent MAA. Several patients presented antibody combinations. Further studies are needed to fully associate phenotypes with antibodies.
Collapse
Affiliation(s)
- Andrés Hormaza-Jaramillo
- Unidad de Reumatología, Fundación Valle del Lili, Cali, Colombia
- *Correspondence: Andrés Hormaza-Jaramillo,
| | - Vanessa Bedoya-Joaqui
- Unidad de Reumatología, Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia
| | - Germán Puerta-Sarmiento
- Unidad de Reumatología, Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia
| | - Mario Bautista
- Unidad de Reumatología, Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia
| | - Lady J. Rios-Serna
- Centro de Investigación en Reumatología, Autoinmunidad y Medicina Traslacional, Universidad ICESI, Cali, Colombia
| | | | | | - Ingrid Ruiz-Ordoñez
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| |
Collapse
|
26
|
Galindo-Feria AS, Wang G, Lundberg IE. Autoantibodies: Pathogenic or epiphenomenon. Best Pract Res Clin Rheumatol 2022; 36:101767. [PMID: 35810122 DOI: 10.1016/j.berh.2022.101767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Idiopathic inflammatory myopathies (IIM) are heterogeneous autoimmune diseases. There are distinct subgroups, including antisynthetase syndrome, dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, and sporadic inclusion body myositis. In patients with IIM, autoantibodies are present in up to 80% of the patients. These autoantibodies are often characterized as myositis-specific autoantibodies (MSA) or myositis-associated autoantibodies (MAA). The recognition of the importance of autoantibodies, especially MSA, is increasing in recent years. In this chapter, we provide an overview of the MSAs, including some new autoantibodies of interest as they target mainly muscle-specific autoantigen, in clinical classification, the measurement of the disease activity, and a possible role in the pathogenesis in the patients with IIM.
Collapse
Affiliation(s)
- Angeles S Galindo-Feria
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
| | - Guochun Wang
- Department of Rheumatology, Key Laboratory of Myositis, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden; Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
| |
Collapse
|
27
|
Galindo-Feria AS, Notarnicola A, Lundberg IE, Horuluoglu B. Aminoacyl-tRNA Synthetases: On Anti-Synthetase Syndrome and Beyond. Front Immunol 2022; 13:866087. [PMID: 35634293 PMCID: PMC9136399 DOI: 10.3389/fimmu.2022.866087] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/28/2022] [Indexed: 12/20/2022] Open
Abstract
Anti-synthetase syndrome (ASSD) is an autoimmune disease characterized by the presence of autoantibodies targeting one of several aminoacyl t-RNA synthetases (aaRSs) along with clinical features including interstitial lung disease, myositis, Raynaud’s phenomenon, arthritis, mechanic’s hands, and fever. The family of aaRSs consists of highly conserved cytoplasmic and mitochondrial enzymes, one for each amino acid, which are essential for the RNA translation machinery and protein synthesis. Along with their main functions, aaRSs are involved in the development of immune responses, regulation of transcription, and gene-specific silencing of translation. During the last decade, these proteins have been associated with cancer, neurological disorders, infectious responses, and autoimmune diseases including ASSD. To date, several aaRSs have been described to be possible autoantigens in different diseases. The most commonly described are histidyl (HisRS), threonyl (ThrRS), alanyl (AlaRS), glycyl (GlyRS), isoleucyl (IleRS), asparaginyl (AsnRS), phenylalanyl (PheRS), tyrosyl (TyrRS), lysyl (LysRS), glutaminyl (GlnRS), tryptophanyl (TrpRS), and seryl (SerRS) tRNA synthetases. Autoantibodies against the first eight autoantigens listed above have been associated with ASSD while the rest have been associated with other diseases. This review will address what is known about the function of the aaRSs with a focus on their autoantigenic properties. We will also describe the anti-aaRSs autoantibodies and their association to specific clinical manifestations, and discuss their potential contribution to the pathogenesis of ASSD.
Collapse
Affiliation(s)
- Angeles S. Galindo-Feria
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Antonella Notarnicola
- Center for Molecular Medicine, Karolinska Institutet, and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Ingrid E. Lundberg
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, and Karolinska University Hospital Solna, Stockholm, Sweden
| | - Begum Horuluoglu
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska Institutet, and Karolinska University Hospital Solna, Stockholm, Sweden
- *Correspondence: Begum Horuluoglu,
| |
Collapse
|
28
|
Skemp-Dymond G, Lebiedz-Odrobina D, Zuromski LM, Rhoads JLW, Tebo AE. Assessment of a Line Immunoassay for the Detection of Mi-2 Antibodies: Results From a Single Academic Center Investigation. Am J Clin Pathol 2022; 157:506-509. [PMID: 34661646 DOI: 10.1093/ajcp/aqab150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/30/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To evaluate the performance characteristics of a line immunoassay (LIA) for the detection of Mi-2 antibodies associated with dermatomyositis (DM). METHODS In total, 432 consecutive patient specimens were tested for Mi-2 antibodies concurrently by LIA (Mi-2α or Mi-2β) or immunoprecipitation (IP) test and antinuclear antibody by indirect immunofluorescence assay using HEp-2 substrate. Following antibody evaluation, results for patients positive in any of the assays for Mi-2 antibody had a retrospective chart review for diagnostic categorization. The performance of all tests was evaluated based on the extracted clinical data. RESULTS Forty patients were positive in at least one of the Mi-2 assays. The frequency of Mi-2β antibody by LIA was highest (75.0%), followed by Mi-2 by IP (35.0%) and Mi-2α by LIA (20.0%), respectively. Mi-2 by IP had the best total percent agreement for DM (95.0%) compared with 70.0% and 25.0% for the LIA Mi-2α and Mi-2β, respectively. Positivity of the Mi-2β antibody was significantly associated with non-DM diagnosis. CONCLUSIONS Agreement for DM with assays for detecting Mi-2 is variable. Additional studies are required to validate Mi-2 immunoassays for routine patient evaluation.
Collapse
Affiliation(s)
| | - Dorota Lebiedz-Odrobina
- Internal Medicine, Salt Lake City, UT, USA
- George E. Whalen VA Medical Center, Salt Lake City, UT, USA
| | - Lauren M Zuromski
- ARUP Institute of Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | | | - Anne E Tebo
- ARUP Institute of Clinical and Experimental Pathology, Salt Lake City, UT, USA
- Pathology, University of Utah Health, Salt Lake City, UT, USA
| |
Collapse
|
29
|
Notarnicola A, Preger C, Lundström SL, Renard N, Wigren E, Van Gompel E, Galindo-Feria AS, Persson H, Fathi M, Grunewald J, Jakobsson PJ, Gräslund S, Lundberg IE, Fernandes-Cerqueira C. Longitudinal assessment of reactivity and affinity profile of anti-Jo1 autoantibodies to distinct HisRS domains and a splice variant in a cohort of patients with myositis and anti-synthetase syndrome. Arthritis Res Ther 2022; 24:62. [PMID: 35236390 PMCID: PMC8889758 DOI: 10.1186/s13075-022-02745-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 02/13/2022] [Indexed: 02/08/2023] Open
Abstract
Background To address the reactivity and affinity against histidyl-transfer RNA synthetase (HisRS) autoantigen of anti-Jo1 autoantibodies from serum and bronchoalveolar lavage fluid (BALF) in patients with idiopathic inflammatory myopathies/anti-synthetase syndrome (IIM/ASSD). To investigate the associations between the reactivity profile and clinical data over time. Methods Samples and clinical data were obtained from (i) 25 anti-Jo1+ patients (19 sera with 16 longitudinal samples and 6 BALF/matching sera at diagnosis), (ii) 29 anti-Jo1− patients (25 sera and 4 BALF/matching sera at diagnosis), and (iii) 27 age/gender-matched healthy controls (24 sera and 3 BALF/matching sera). Reactivity towards HisRS full-length (HisRS-FL), three HisRS domains (WHEP, antigen binding domain (ABD), and catalytic domain (CD)), and the HisRS splice variant (SV) was tested. Anti-Jo1 IgG reactivity was evaluated by ELISA and western blot using IgG purified from serum by affinity chromatography. In paired serum-BALF, anti-Jo1 IgG and IgA reactivity was analyzed by ELISA. Autoantibody affinity was measured by surface plasmon resonance using IgG purified from sera. Correlations between autoantibody reactivity and clinical data were evaluated at diagnosis and longitudinally. Results Anti-Jo1 IgG from serum and BALF bound HisRS-FL, WHEP, and SV with high reactivity at the time of diagnosis and recognized both conformation-dependent and conformation-independent HisRS epitopes. Anti-HisRS-FL IgG displayed high affinity early in the disease. At the time of IIM/ASSD diagnosis, the highest autoantibody levels against HisRS-FL were found in patients ever developing interstitial lung disease (ILD) and arthritis, but with less skin involvement. Moreover, the reactivity of anti-WHEP IgG in BALF correlated with poor pulmonary function. Levels of autoantibodies against HisRS-FL, HisRS domains, and HisRS splice variant generally decreased over time. With some exceptions, longitudinal anti-HisRS-FL antibody levels changed in line with ILD activity. Conclusion High levels and high-affinity anti-Jo1 autoantibodies towards HisRS-FL were found early in disease in sera and BALF. In combination with the correlation of anti-HisRS-FL antibody levels with ILD and ILD activity in longitudinal samples as well as of anti-WHEP IgG in BALF with poor pulmonary function, this supports the previously raised hypothesis that the lung might have a role in the immune reaction in anti-Jo1-positive patients. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02745-6.
Collapse
Affiliation(s)
- Antonella Notarnicola
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden. .,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Charlotta Preger
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Structural Genomics Consortium, Toronto, Canada
| | - Susanna L Lundström
- Division of Physiological Chemistry I, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Solnavägen 9, SE-171 77, Stockholm, Sweden
| | - Nuria Renard
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Edvard Wigren
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Structural Genomics Consortium, Toronto, Canada
| | - Eveline Van Gompel
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Laboratory of Tissue Homeostasis and Disease, Skeletal Biology and Engineering Research Center, KULeuven, Leuven, Belgium
| | - Angeles S Galindo-Feria
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Persson
- Science for Life Laboratory, Drug Discovery and Development, Stockholm, Sweden.,School of Engineering Sciences in Chemistry, Biotechnology and Health, Royal Institute of Technology (KTH), Stockholm, Sweden
| | - Maryam Fathi
- Department of Respiratory Medicine and Allergy, J7:30, Bioclinicum, Karolinska University Hospital, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Johan Grunewald
- Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Respiratory Medicine and Allergy, J7:30, Bioclinicum, Karolinska University Hospital, Karolinska Institutet, SE-171 76, Stockholm, Sweden
| | - Per-Johan Jakobsson
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Gräslund
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Structural Genomics Consortium, Toronto, Canada
| | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Cátia Fernandes-Cerqueira
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, SE-171 64, Solna, Stockholm, Sweden.,Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,4Dcell, 14 rue de la Beaune, 93100, Montreuil, France
| |
Collapse
|
30
|
Arase N, Tsuji H, Takamatsu H, Jin H, Konaka H, Hamaguchi Y, Tonomura K, Kotobuki Y, Ueda-Hayakawa I, Matsuoka S, Hirano T, Yorifuji H, Murota H, Ohmura K, Nakashima R, Sato T, Kumanogoh A, Katayama I, Arase H, Fujimoto M. Cell surface-expressed Ro52/IgG/HLA-DR complex is targeted by autoantibodies in patients with inflammatory myopathies. J Autoimmun 2021; 126:102774. [PMID: 34896887 DOI: 10.1016/j.jaut.2021.102774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
Intracellular proteins are often targeted by autoantibodies in autoimmune diseases; however, the mechanism through which intracellular molecules are targeted remains unknown. We previously found that several intracellular misfolded proteins are transported to the cell surface by HLA class II molecules and are recognized by autoantibodies in some autoimmune diseases, such as rheumatoid arthritis, antiphospholipid syndrome, and microscopic polyangiitis. Ro52 is an intracellular Fc receptor that is a target antigen for myositis-associated autoantibodies. We analyzed the role of HLA class II molecules in the autoantibody recognition of Ro52. Ro52 alone was not transported to the cell surface by HLA class II molecules; however, it was transported to the cell surface in the presence of both IgG heavy chain and HLA class II molecules to form a Ro52/IgG/HLA-DR complex. The Ro52/IgG/HLA-DR complex was specifically recognized by autoantibodies from some patients with inflammatory myopathies. We then evaluated 120 patients with inflammatory myopathies with four types of myositis-specific antibodies and analyzed the autoantibodies against the Ro52/IgG/HLA-DR complex. The specific antibodies against the Ro52/IgG/HLA-DR complex were detected in 90% and 93% of patients who were positive for anti-MDA5 and anti-ARS antibodies, respectively. In individual patients with these two inflammatory myopathies, changes in serum titers of anti-Ro52/IgG/HLA-DR-specific antibodies were correlated with the levels of KL-6 (R = 0.51 in anti-MDA5 antibody-positive DM patients, R = 0.67 in anti-ARS antibody-positive PM/DM patients with respiratory symptoms) and CK (R = 0.63 in anti-ARS antibody-positive PM/DM patients with muscle symptoms) over time. These results suggest that antibodies against Ro52/IgG/HLA-DR expressed on the cell surface could be involved in the pathogenesis of inflammatory myopathy subgroups.
Collapse
Affiliation(s)
- Noriko Arase
- Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Hideaki Tsuji
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Hui Jin
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Hachiro Konaka
- Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Kyoko Tonomura
- Osaka University Graduate School of Medicine, Osaka, Japan
| | | | | | - Sumiko Matsuoka
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Toru Hirano
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideki Yorifuji
- Osaka University Graduate School of Medicine, Osaka, Japan; Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Hiroyuki Murota
- Osaka University Graduate School of Medicine, Osaka, Japan; Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | | | - Ran Nakashima
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoharu Sato
- Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Kumanogoh
- Osaka University Graduate School of Medicine, Osaka, Japan; World Premier International Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Ichiro Katayama
- Osaka University Graduate School of Medicine, Osaka, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hisashi Arase
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan; World Premier International Immunology Frontier Research Center, Osaka University, Osaka, Japan
| | - Manabu Fujimoto
- Osaka University Graduate School of Medicine, Osaka, Japan; World Premier International Immunology Frontier Research Center, Osaka University, Osaka, Japan
| |
Collapse
|
31
|
Abstract
Systemic diseases can cause heart block owing to the involvement of the myocardium and thereby the conduction system. Younger patients (<60) with heart block should be evaluated for an underlying systemic disease. These disorders are classified into infiltrative, rheumatologic, endocrine, and hereditary neuromuscular degenerative diseases. Cardiac amyloidosis owing to amyloid fibrils and cardiac sarcoidosis owing to noncaseating granulomas can infiltrate the conduction system leading to heart block. Accelerated atherosclerosis, vasculitis, myocarditis, and interstitial inflammation contribute to heart block in rheumatologic disorders. Myotonic, Becker, and Duchenne muscular dystrophies are neuromuscular diseases involving the myocardium skeletal muscles and can cause heart block.
Collapse
|
32
|
Lee AYS, Reed JH, Gordon TP. Anti-Ro60 and anti-Ro52/TRIM21: Two distinct autoantibodies in systemic autoimmune diseases. J Autoimmun 2021; 124:102724. [PMID: 34464814 DOI: 10.1016/j.jaut.2021.102724] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 11/27/2022]
Abstract
As iconic and important diagnostic autoantibodies, anti-Ro60 and anti-Ro52/tri-partite motif-containing 21 (TRIM21) make a common appearance in a number of systemic autoimmune disorders such as systemic lupus erythematosus (SLE). These autoantibodies often co-exist together; yet despite their close relationship, there is no evidence that they are physically linked and probably reflect a convergence of separate processes of failed immunological tolerance. Confusingly, they are sometimes classed together as the "SSA" or "Ro" autoantibody system without clear distinction between the two. In this Short Communication, we discuss the diagnostic merits for separate detection and reporting of these two autoantibodies, and discuss avenues for future research. Indeed, further insight into their fascinating origins and pathogenic roles in autoimmunity will surely shed light on how we can prevent and treat devastating autoimmune disorders.
Collapse
Affiliation(s)
- Adrian Y S Lee
- Department of Immunology, Westmead Hospital & ICPMR, Westmead, NSW, Australia; Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia.
| | - Joanne H Reed
- Garvan Institute of Medical Research, Darlinghurst, NSW, Australia; St Vincent's Clinical School, Faculty of Medicine, UNSW, Sydney, NSW, Australia
| | - Tom P Gordon
- Department of Immunology, SA Pathology and Flinders Medical Centre, Bedford Park, SA, Australia; Department of Immunology, Flinders University, Bedford Park, SA, Australia
| |
Collapse
|
33
|
Biomarker und Histologie bei idiopathischen inflammatorischen Myopathien. AKTUEL RHEUMATOL 2021. [DOI: 10.1055/a-1548-8934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ZusammenfassungDie idiopathischen inflammatorischen Myopathien (IIM) sind eine Gruppe entzündlicher Muskelerkrankungen für deren Diagnosestellung, Verlaufsbeurteilung, Prognoseabschätzung und Risikostratifizierung Biomarker eine jeweils essentielle Rolle spielen. Biomarker in diesem Kontext können sowohl „herkömmliche“ serologische Marker wie Muskelenzyme oder Autoantikörper, histologische Marker wie entitätsspezifische inflammatorische Muster, aber auch genomische und genetische Marker sein. Der vorliegende Artikel gibt einen Überblick über bewährte und innovative Marker.
Collapse
|
34
|
Gómez GN, Pérez N, Braillard Poccard A, Gómez RA, Costi AC, García MA, Viola M, Benitez A, Aciar MM, Crespo Espíndola M, Yucra D, Cosatti MA, Pisoni C, Capelusnik D, Lojo MN, Barrios BI, Rivero M, Kisluk B, Granel A. Myositis-specific antibodies and clinical characteristics in patients with autoimmune inflammatory myopathies: reported by the Argentine Registry of Inflammatory Myopathies of the Argentine Society of Rheumatology. Clin Rheumatol 2021; 40:4473-4483. [PMID: 34159491 DOI: 10.1007/s10067-021-05797-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/04/2021] [Accepted: 05/25/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION/OBJECTIVES To describe clinical features in patients with inflammatory myopathies (IMs) from the Argentine Registry of Inflammatory Myopathies, and their relationship with myositis-specific antibodies (MSAs). METHODS This cross-sectional study included 360 adult patients with dermatomyositis (DM), polymyositis (PM), and inclusion body myositis. Demographics, clinical, and serological characteristics were retrospectively recorded (2016-2019). MSAs were determined by immunoblotting. Patients who were positive for anti-Jo-1, Mi-2, and MDA5 were compared against a group of patients, taken as reference group, who were negative for all MSAs. RESULTS Women 72%, median age at diagnosis was 47.3 years (18-82). The most frequent subtypes were DM (43.9%) followed by PM (30%).The most frequent MSAs were anti-Jo-1 (51/317), 16.1%; MDA5 (12/111), 10.8%, and Mi-2 (23/226), 10.2%. Anti-Jo-1 was associated (p < 0.05) with a higher frequency of chronic disease course, interstitial lung disease (ILD), arthritis, and mechanic's hands. Anti-Mi-2 was found in patients who had higher frequency of skin manifestations and higher CK values (p < 0.001). Patients with anti-MDA5 had normal or low CK levels. Anti-MDA5 was associated (p < 0.05) with skin manifestations, arthritis, and ILD. The rest of MSAs had frequencies lower than 8%. Anti-TIF1ϒ was found in eight DM patients and one had cancer. Anti-SRP was found in seven patients who had PM and elevated CK. CONCLUSION Anti-Jo-1 was the most frequent MSA, and was associated with ILD; MDA5 was associated with CADM and ILD, and Mi-2, with classical DM. Despite the different prevalence with respect to other cohorts, the clinical characteristics for each MSA group were similar to the data reported in other studies. Key Points • This study describes the prevalence of MSAs in the Argentine Registry of IMs. • Anti-Jo-1 and anti-MDA5 were associated with ILD. • Anti-Mi-2 was the third most frequent MSA, associated with classical DM.
Collapse
Affiliation(s)
- Graciela N Gómez
- Department of Immunology, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires University, Autonomous City of Buenos Aires, 3150 Combatientes de Malvinas Ave, 1431, PC, Argentina.
| | - Nicolás Pérez
- Department of Immunology, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires University, Autonomous City of Buenos Aires, 3150 Combatientes de Malvinas Ave, 1431, PC, Argentina
| | - Andrea Braillard Poccard
- Department of Rheumatology, Hospital de Clínicas, José de San Martín, Buenos Aires University, Autonomous City of Buenos Aires, Argentina
| | - Ramiro A Gómez
- Department of Rheumatology, Hospital de Clínicas, José de San Martín, Buenos Aires University, Autonomous City of Buenos Aires, Argentina
| | - Ana C Costi
- Department of Rheumatology, Province of Buenos Aires, H.I.G.A San Martín, La Plata City, Argentina
| | - Mercedes A García
- Department of Rheumatology, Province of Buenos Aires, H.I.G.A San Martín, La Plata City, Argentina
| | - Malena Viola
- Department of Rheumatology, Hospital General de Agudos Dr. Cosme Argerich, Autonomous City of Buenos Aires, Argentina
| | - Alejandro Benitez
- Department of Rheumatology, Hospital General de Agudos Dr. Cosme Argerich, Autonomous City of Buenos Aires, Argentina
| | - Mariana M Aciar
- Department of Rheumatology, Hospital Nuestro Señor del Milagro, Salta City, Province of Salta, Argentina
| | - María Crespo Espíndola
- Department of Rheumatology, Hospital Nuestro Señor del Milagro, Salta City, Province of Salta, Argentina
| | - Demelza Yucra
- Department of Rheumatology, Sanatorio Güemes, Autonomous City of Buenos Aires, Argentina
| | - Micaela A Cosatti
- Department of Rheumatology, CEMIC, Autonomous City of Buenos Aires, Argentina
| | - Cecilia Pisoni
- Department of Rheumatology, CEMIC, Autonomous City of Buenos Aires, Argentina
| | - Dafne Capelusnik
- Department of Rheumatology, Instituto de Rehabilitación Psicofsica (IREP), Autonomous City of Buenos Aires, Argentina
| | - María N Lojo
- Department of Rheumatology, Hospital Rossi, La Plata City, Province of Buenos Aires, Argentina
| | - Belen I Barrios
- Department of Rheumatology, Hospital Enrique Tornú, Autonomous City of Buenos Aires, Argentina
| | - Mariano Rivero
- Department of Rheumatology, British Hospital, Autonomous City of Buenos Aires, Argentina
| | - Boris Kisluk
- Department of Rheumatology, Hospital Eva Perón, Granadero Baigorria City, Province of Santa Fe, Argentina
| | - Amelia Granel
- Department of Rheumatology, Hospital San Roque, La Plata City, Province of Buenos Aires, Argentina
| |
Collapse
|
35
|
Shao C, Sun Y, Huang H, Zhang Z, Pan R, Xu K, Zhang X, Zhang Y, Xu Z. Myositis specific antibodies are associated with isolated anti-Ro-52 associated interstitial lung disease. Rheumatology (Oxford) 2021; 61:1083-1091. [PMID: 34128956 DOI: 10.1093/rheumatology/keab488] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/28/2021] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Anti-Ro-52 antibody positivity might be associated with the presence of interstitial lung disease (ILD) among patients with autoimmune features. However, the clinical significance of isolated anti-Ro-52 positivity (i.e., the presence of anti-Ro52 antibodies but the absence of anti-Ro60 antibodies; anti-Ro52+-Ro60-) in patients with ILD is not clear. METHODS This is a prospective and observational study of Chinese ILD patients with isolated anti-Ro-52 positivity. According to their myositis-specific antibody (MSA) status, patients were split into groups, and their clinical and radiological features were compared. RESULTS Of the 158 enrolled patients with ILD and isolated anti-Ro-52 positivity (isolated anti-Ro-52-ILD), there were 130 patients with a positive MSA status and 28 patients with a negative MSA status. Anti-synthetase antibodies (ASAs) were found in 61.5% of patients with MSA+ ILD, and anti-melanoma differentiated-associated protein 5 (MDA-5) antibodies were found in the remaining 38.5% of patients. The anti-nuclear antibody (ANA) pattern was associated with ASA and anti-MDA-5 positivity (χ2=70.7, P < 0.001; Cramer's value 0.47, P < 0.001): ANA negativity was associated with anti-MDA-5 positivity, and cytoplasmic ANA positivity was associated with ASA positivity. There were statistically significant differences in the high-resolution CT patterns between patients with isolated anti-Ro-52 positivity with different MSA statuses (χ2=29.8, P < 0.001; Cramer's value 0.31, P < 0.001): OP pattern was more common in patients with anti-MDA-5 antibodies than in those without anti-MDA-5 antibodies. CONCLUSIONS Patients with isolated anti-Ro-52-ILD showed high positivity of MSA. Isolated anti-Ro-52 positivity with cytoplasmic ANA positivity was strongly associated with ASA+-ILD, while ANA negativity was associated with anti-MDA-5+-ILD.
Collapse
Affiliation(s)
- Chi Shao
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuxin Sun
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hui Huang
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zeyu Zhang
- The First Clinical College, Chongqing Medical University, Chongqing, China
| | - Ruili Pan
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kai Xu
- Radiological Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Zhang
- Medical Records Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ying Zhang
- International Medical Service Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zuojun Xu
- Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
36
|
Van Horebeek N, Vulsteke JB, Bossuyt X, Claeys KG, Dillaerts D, Poesen K, Lenaerts J, Van Damme P, Blockmans D, De Haes P, De Langhe E. Detection of multiple myositis-specific autoantibodies in unique patients with idiopathic inflammatory myopathy: A single centre-experience and literature review: Systematic review. Semin Arthritis Rheum 2021; 51:486-494. [PMID: 33831755 DOI: 10.1016/j.semarthrit.2021.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/23/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Myositis-specific autoantibodies (MSAs) are thought to be mutually exclusive in patients with idiopathic inflammatory myopathies (IIM) based on studies with immunoprecipitation-based (IP) detection methods. Recently, detection of multiple MSAs in unique patients is increasingly reported, but the extent of this phenomenon remains unclear. METHODS At our centre, we reviewed results from two line immunoassays and one dot immunoassay in 145 IIM patients and 240 controls for the presence of multiple MSAs. Pubmed and Embase were systematically searched for articles mentioning detection of multiple MSAs in IIM patients, published until February 2019. We assessed the frequency, detection method, the precise combinations and clinical phenotypes of participants with multiple MSAs. RESULTS At our centre, detection of multiple MSAs occurred in 3.4-8.3% of patients with IIM, depending on the assay. However, no cases with full concordance across all three assays were identified. Forty-four articles reported detection of multiple MSAs, representing a total of 133 cases, including four patients with a connective tissue disease other than IIM and two healthy controls. In 101 cases all MSAs were detected using only one detection method: 40 cases with IP-based methods (most frequently used technique) and 61 cases with other assay types. In most cases the phenotype of patients with multiple MSAs matched the predicted presentation associated with one MSA and in few cases the phenotype matched with both MSAs. CONCLUSION Detection of multiple MSAs in unique IIM patients is less rare than commonly accepted. Specificity issues of the commercially available multiplex immunoassays may, at least partly, explain the higher frequency compared to IP-based methods. 'True multiple MSA-positive' patients may exist, though they are most likely rare.
Collapse
Affiliation(s)
- Nele Van Horebeek
- General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Jean-Baptiste Vulsteke
- Rheumatology, University Hospitals Leuven, Leuven, Belgium; KU Leuven Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Laboratory of Tissue Homeostasis and Disease
| | - Xavier Bossuyt
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; Clinical and Diagnostic Immunology, KU Leuven, Leuven, Belgium
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium; KU Leuven, Laboratory for Muscle Diseases and Neuropathies, Leuven, Belgium
| | | | - Koen Poesen
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium; KU Leuven, Laboratory for Molecular Neurobiomarker Research, Leuven, Belgium
| | - Jan Lenaerts
- Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Philip Van Damme
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium; KU Leuven, Department of Neurosciences, Experimental Neurology, VIB Centre for Brain and Disease Research, Laboratory of Neurobiology, Leuven, Belgium
| | - Daniel Blockmans
- General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Petra De Haes
- Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Ellen De Langhe
- Rheumatology, University Hospitals Leuven, Leuven, Belgium; KU Leuven Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Laboratory of Tissue Homeostasis and Disease.
| |
Collapse
|
37
|
Hodgkinson LM, Wu TT, Fiorentino DF. Dermatomyositis autoantibodies: how can we maximize utility? ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:433. [PMID: 33842654 PMCID: PMC8033377 DOI: 10.21037/atm-20-5175] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The past 15 years has seen significant advances in the characterization of myositis-specific autoantibodies (MSAs) and their associated phenotypes in patients with dermatomyositis (DM). As more careful studies are performed, it is clear that unique combinations of clinical and pathological phenotypes are associated with each MSA, despite the fact that there is considerable heterogeneity within antibody classes as well as overlap across the groups. Because risk for interstitial lung disease (ILD), internal malignancy, adverse disease trajectory, and, potentially response to therapy differ by DM MSA group, a deeper understanding of MSAs and validation and standardization of assays used for detection are critical for optimizing diagnosis and treatment. Like any test, the diagnostic sensitivity and specificity of assays for various MSAs is not perfect. Currently tests for MSAs are helpful at minimum for a clinician to assess relative risk or contribute to diagnosis and perhaps counsel the appropriate patient about what to expect. With international standardization and larger studies it is likely that more antibody tests will make their way into formal schemata for diagnosis and actionable risk assessment in DM. In this review, we summarize key considerations for interpreting the clinical and pathologic associations with MSA in DM and identify critical gaps in knowledge and practice that will maximize their clinical utility and utility for understanding disease pathogenesis.
Collapse
Affiliation(s)
| | - Tiffany Tingshuen Wu
- Department of Dermatology, Stanford University School of Medicine, Redwood City, CA, USA
| | | |
Collapse
|
38
|
Khan AM, Ahmad F, Rehman U, Jindal H, Harimohan H. A Clinical Case of Polymyositis Complicated by Antisynthetase Syndrome. Cureus 2021; 13:e12737. [PMID: 33614339 PMCID: PMC7883527 DOI: 10.7759/cureus.12737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 11/26/2022] Open
Abstract
Antisynthetase syndrome is an autoimmune condition that manifests clinically through signs and symptoms, such as interstitial lung disease, myositis, Raynaud's phenomenon, fever, hyperkeratotic fingertips (mechanic's hands), and arthritis. It is associated with antibodies against aminoacyl tRNA synthetase enzyme, the most common autoantibody being the anti-Jo-1. An 18-year-old girl presented with weakness of both the upper and lower limb, swelling and generalized body pain, difficulty in swallowing. MRI of the thigh was highly suggestive of myositis with symmetrical bilateral involvement. Based on proximal muscle weakness, elevated creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), strongly positive anti-nuclear antibodies human epithelial cell type-2 (ANA-HEp2), and a normal nerve conduction velocity test with precise MRI findings, a diagnosis of polymyositis was made. She was given bolus intravenous methylprednisolone for five days, followed by oral methylprednisolone with subcutaneous methotrexate weekly. She reported a 50% improvement in muscle weakness; however, partial bulbar weakness persisted at the time of discharge. On her next follow-up, her blood investigations for auto-antibodies were done. The autoantibodies anti-Jo-1 (3+), Ro-52 (2+), and Mi-2β (2+) were found to be positive. These investigations, coupled with the clinical features she was presenting, finally led us to conclude that it was a case of polymyositis complicated by the antisynthetase syndrome.
Collapse
Affiliation(s)
- Aadil M Khan
- Internal Medicine, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND
| | - Faim Ahmad
- Internal Medicine, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, IND
| | | | - Himanshu Jindal
- General Medicine, Ganesh Shankar Vidyarthi Memorial Medical College and Lala Lajpat Rai Hospital, Kanpur, IND
| | - Hridya Harimohan
- Internal Medicine, Kerala Institute of Medical Sciences, Trivandrum, IND
| |
Collapse
|
39
|
郑 艺, 郝 洪, 刘 怡, 郭 晶, 赵 亚, 张 巍, 袁 云. [Correlation study on anti-Ro52 antibodies frequently co-occur with other myositis-specific and myositis-associated autoantibodies]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 52:1088-1092. [PMID: 33331318 PMCID: PMC7745287 DOI: 10.19723/j.issn.1671-167x.2020.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Anti-Ro52 antibodies are frequently co-occur with other myositis-specific and myositis-associated autoantibodies, we here to study this phenomenon in Chinese patients suspected with inflammatory myopathies. METHODS In the study, 1 509 patients clinically suspected with inflammatory myopathies were tested for 11 kinds of myositis-specific and myositis-associated autoantibodies (including: anti-Jo-1, PL-7, PL-12, EJ, OJ, Mi-2, SRP, Ku, PM-Scl 75, PM-Scl 100, and Ro52 antibo-dies) by line-blot immunoassay from 2010 to 2016 in Peking University First Hospital. This retrospective study was to analyze these results to reveal the characteristics of anti-Ro52 antibodies co-occuring with other myositis autoantibodies. The data were analyzed using SPSS 17.0 and Graph Pad PRISM for Chi-square test, independent t-test, Pearson's correlation analysis, and drawing statistical graphs. Significance level was set at P < 0.05. RESULTS The positive rate of anti-Ro52 antibodies was 18.3% (276/1 509 cases), which was the most frequently detected myositis antibodies in our center. 51.8% (143/276) of the patients with anti-Ro52 antibodies were combined with the other myositis antibodies, and the most common co-occurred antibodies were anti-SRP antibodies (18.8%, 52/276), and the second common co-occurred antibodies were anti-Jo-1 antibodies (13.0%, 36/276). Anti-Ro52 antibodies were the most common antibodies that co-occurred in other myositis antibodies positive patients except in anti-OJ antibodies positive group. The co-positive rate with anti-Ro52 antibodies was the lowest in anti-PM-Scl 75 positive group (30.4%, 31/102), and the highest in anti-EJ positive group (80.0%, 12/15). The positive rate of anti-Ro52 antibodies in anti-synthase antibodies (including anti-Jo-1, EJ, OJ, PL-7, and PL-12 antibodies) positive group was 57.3% (75/131), which was significantly higher than that in the other antibodies (including: anti-Mi-2, SRP, Ku, PM-Scl 75, and PM-Scl 100 antibodies) positive group with 35.2% (119/338) (χ2=18.916, P < 0.001). The intensity of anti-Jo-1, EJ, and SRP antibodies in the group of the patients that co-occurred with anti-Ro52 antibodies was significantly higher than that in the other group without anti-Ro52 antibodies respectively (P < 0.05). The intensity of anti-SRP antibodies was significantly correlated with that of anti-Ro52 antibodies (r=0.44, P=0.001). CONCLUSION Anti-Ro52 antibodies were commonly associated with other myositis-specific and myositis-associated autoantibodies, especially with anti-synthase antibodies, and the co-presence of anti-Ro52 antibodies may be correlated with the myositis antibody intensity.
Collapse
Affiliation(s)
- 艺明 郑
- />北京大学第一医院神经内科,北京 100034Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - 洪军 郝
- />北京大学第一医院神经内科,北京 100034Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - 怡琳 刘
- />北京大学第一医院神经内科,北京 100034Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - 晶 郭
- />北京大学第一医院神经内科,北京 100034Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - 亚雯 赵
- />北京大学第一医院神经内科,北京 100034Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - 巍 张
- />北京大学第一医院神经内科,北京 100034Department of Neurology, Peking University First Hospital, Beijing 100034, China
| | - 云 袁
- />北京大学第一医院神经内科,北京 100034Department of Neurology, Peking University First Hospital, Beijing 100034, China
| |
Collapse
|
40
|
Huang K, Aggarwal R. Antisynthetase syndrome: A distinct disease spectrum. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2020; 5:178-191. [PMID: 35382516 PMCID: PMC8922626 DOI: 10.1177/2397198320902667] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/11/2019] [Indexed: 07/28/2023]
Abstract
The discovery of novel autoantibodies related to idiopathic inflammatory myopathies (collectively referred to as myositis) has not only advanced our understanding of the clinical, serological, and pathological correlation in the disease spectrum but also played a role in guiding management and prognosis. One group of the myositis-specific autoantibodies is anti-aminoacyl-tRNA synthetase (anti-ARS or anti-synthetase) which defines a syndrome with predominant interstitial lung disease, arthritis, and myositis. Autoantibodies to eight aminoacyl-tRNA synthetases have been identified with anti-Jo1 the most common in all of idiopathic inflammatory myopathies. Disease presentation and prognosis vary depending on which anti-aminoacyl-tRNA synthetase antibody is present. In this review, we will discuss the clinical characteristics, overlap features with other autoimmune diseases, prognostic factors, and management of the antisynthetase syndrome.
Collapse
Affiliation(s)
- Kun Huang
- Division of Rheumatology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Rohit Aggarwal
- Arthritis and Autoimmunity Center and UPMC Myositis Center, Division of Rheumatology and Clinical Immunology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
41
|
Stochmal A, Czuwara J, Trojanowska M, Rudnicka L. Antinuclear Antibodies in Systemic Sclerosis: an Update. Clin Rev Allergy Immunol 2020; 58:40-51. [PMID: 30607749 DOI: 10.1007/s12016-018-8718-8] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Systemic sclerosis is an autoimmune disease characterized by fibrosis of skin and internal organs, vasculopathy, and dysregulation of immune system. A diagnostically important feature of immunological abnormalities in systemic sclerosis is the presence of circulating antinuclear antibodies, which may be detected in 90-95% of patients with either of the four main laboratory methods: immunofluorescence, enzyme-linked immunosorbent assay, immunodiffusion, and immunoblotting. There are several antinuclear antibodies specific for systemic sclerosis. These include antibodies against topoisomerase (anti-TOPO I), kinetochore proteins (ACA), RNA polymerase enzyme (anti-RNAP III), ribonuclear proteins (anti-U11/U12 RNP, anti-U1 RNP, anti-U3 RNP) and nucleolar antigens (anti-Th/To, anti-NOR 90, anti-Ku, antiRuvBL1/2, and anti-PM/Scl). Autoantibodies specific for systemic sclerosis have been linked to distinct clinical features. Therefore, detecting a particular antibody type is important in predicting a possible organ involvement and prognosis and may have an impact on monitoring and treatment.
Collapse
Affiliation(s)
- Anna Stochmal
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008, Warsaw, Poland
| | - Joanna Czuwara
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008, Warsaw, Poland
| | - Maria Trojanowska
- Arthritis Center, Boston University School of Medicine, Boston, MA, USA
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008, Warsaw, Poland.
| |
Collapse
|
42
|
Wermuth PJ, Jimenez SA. Molecular characteristics and functional differences of anti-PM/Scl autoantibodies and two other distinct and unique supramolecular structures known as "EXOSOMES". Autoimmun Rev 2020; 19:102644. [PMID: 32801042 DOI: 10.1016/j.autrev.2020.102644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/10/2020] [Indexed: 02/06/2023]
Abstract
The term "exosome" has been applied to three distinct supramolecular entities, namely the PM/Scl autoantibodies or "RNA exosomes", transforming DNA fragments termed "DNA exosomes", and small size extracellular vesicles knows as "exosomes". Some of the molecular components of the "PM/Scl exosome complex" or "RNA exosome" are recognized by specific autoantibodies present in the serum from some Systemic Sclerosis (SSc), polymyositis (PM) and polymyositis SSc (PM/Scl) overlap syndrome patients. On the other hand, one of the most active focuses of laboratory investigation in the last decade has been the biogenesis and role of extracellular vesicles known as "exosomes". The remarkable ability of these "exosome" vesicles to alter the cellular phenotype following fusion with target cells and the release of their macromolecular cargo has revealed a possible role in the pathogenesis of numerous diseases, including malignant, inflammatory, and autoimmune disorders and may allow them to serve as theranostic agents for personalized and precision medicine. The indiscriminate use of the term "exosome" to refer to these three distinct molecular entities has engendered great confusion in the scientific literature. Here, we review the molecular characteristics and functional differences between the three molecular structures identified as "exosomes". Given the rapidly growing scientific interest in extravesicular exosomes, unless a solution is found the confusion in the literature resulting from the use of the term "exosomes" will markedly increase.
Collapse
Affiliation(s)
- Peter J Wermuth
- Jefferson Institute of Molecular Medicine and Scleroderma Center, Thomas Jefferson University, Philadelphia, PA 19107, USA.
| | - Sergio A Jimenez
- Jefferson Institute of Molecular Medicine and Scleroderma Center, Thomas Jefferson University, Philadelphia, PA 19107, USA
| |
Collapse
|
43
|
Yamamoto M, Tsuzaki K, Itani K, Tachibana N, Inoue M, Hamano T. [A rare case of inclusion body myositis associated with anti-PM/Scl-75 antibodies]. Rinsho Shinkeigaku 2020; 60:264-267. [PMID: 32238743 DOI: 10.5692/clinicalneurol.cn-001363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 71-year-old man presented with progressive muscle weakness of the four limbs in November 2014. His symptoms had started from the left leg in 2008, resulting in frequent falls. In 2011, he became unable to stand up without a handrail due to weakness of the both legs. Physical examination showed almost symmetric muscle weakness of the arms and legs; MMT4. The CK level was slightly elevated of 304 IU/l. The patient was diagnosed as having inclusion body myositis based on the muscle biopsy findings showing many fibers with rimmed vacuoles in addition to mononuclear cell infiltrating into the endomysium, surrounding and sometimes invading into non-necrotic muscle fibers. Anti-PM/Scl-75 antibodies were positive. Muscle strength improved after intravenous immunoglobulin therapy, although the effect was only temporary. This rare case suggests the autoimmunological etiology in inclusion body myositis.
Collapse
Affiliation(s)
- Masayoshi Yamamoto
- Department of Neurology, Kansai Electric Power Hospital.,Department of Neurology, Kitano Hospital, Tazuke Kofukai Medical Research Institute
| | - Koji Tsuzaki
- Department of Neurology, Kansai Electric Power Hospital
| | - Kumi Itani
- Depart of Neurology, Kansai Medical University
| | | | - Manabu Inoue
- Department of Neurology, Osaka City General Hospital
| | | |
Collapse
|
44
|
Wesner N, Uruha A, Suzuki S, Mariampillai K, Granger B, Champtiaux N, Rigolet A, Schoindre Y, Lejeune S, Guillaume-Jugnot P, Vautier M, Hervier B, Simon A, Granier F, Gallay L, Nishino I, Benveniste O, Allenbach Y. Anti-RNP antibodies delineate a subgroup of myositis: A systematic retrospective study on 46 patients. Autoimmun Rev 2020; 19:102465. [PMID: 31918028 DOI: 10.1016/j.autrev.2020.102465] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/05/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Nadège Wesner
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Akinori Uruha
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France; Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1, Musashidai, Fuchu, 183-0042 Tokyo, Japan
| | - Shigeaki Suzuki
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, 160-8582 Tokyo, Japan
| | - Kubéraka Mariampillai
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Benjamin Granger
- Department of Public Health, Pitié Salpétrière Hospital, 84 Boulevard de l'Hôpital, 75013 Paris, France
| | - Nicolas Champtiaux
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Aude Rigolet
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Yoland Schoindre
- Internal Medicine Department, Foch Hospital, 40 Rue Worth, 92150 Suresnes, France
| | - Sylvain Lejeune
- Internal Medicine Department, Avicennes Hospital, 125, rue de Stalingrad, 93000 Bobigny, France
| | - Perrine Guillaume-Jugnot
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Matthieu Vautier
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Baptiste Hervier
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Anne Simon
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Françoise Granier
- Internal Medicine Department, Centre Hospitalier François Quesnay, 62 rue Saint Vincent, 78201 Mantes la Jolie, France
| | - Laure Gallay
- Internal Medicine Department, Hospices Civils de Lyon, Neuro-Myo-Gène Institut, INSERM U1217, 68008 Lyon, France
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience and Department of Genome Medicine Development, Medical Genome Center National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8551 Tokyo, Japan
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Yves Allenbach
- Department of Internal Medicine and Clinical Immunology, Sorbonne Université, University Pierre et Marie et Curie, APHP, Hôpital Pitié-Salpêtrière, Paris, France.
| |
Collapse
|
45
|
|
46
|
Galindo‐Feria AS, Albrecht I, Fernandes‐Cerqueira C, Notarnicola A, James EA, Herrath J, Dastmalchi M, Sandalova T, Rönnblom L, Jakobsson P, Fathi M, Achour A, Grunewald J, Malmström V, Lundberg IE. Proinflammatory Histidyl–Transfer
RNA
Synthetase–Specific
CD
4+ T Cells in the Blood and Lungs of Patients With Idiopathic Inflammatory Myopathies. Arthritis Rheumatol 2019; 72:179-191. [DOI: 10.1002/art.41075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 08/06/2019] [Indexed: 12/30/2022]
Affiliation(s)
| | - Inka Albrecht
- Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | | | | | | | - Jessica Herrath
- Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Maryam Dastmalchi
- Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Tatyana Sandalova
- Science for Life LaboratoryKarolinska Institutet, and Karolinska University Hospital Stockholm Sweden
| | - Lars Rönnblom
- Science for Life Laboratory, Stolkholm, Sweden, and Uppsala University Uppsala Sweden
| | | | | | - Adnane Achour
- Science for Life LaboratoryKarolinska Institutet, and Karolinska University Hospital Stockholm Sweden
| | - Johan Grunewald
- Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Vivianne Malmström
- Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Ingrid E. Lundberg
- Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| |
Collapse
|
47
|
Nakamura Y, Miyanaga R, Shizukawa H, Shimohama S. An Anti-PM/Scl-75 Antibody-positive Japanese Woman Who Developed Inflammatory Myopathy. Intern Med 2019; 58:2689-2693. [PMID: 31178484 PMCID: PMC6794191 DOI: 10.2169/internalmedicine.2402-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
A 69-year-old Japanese woman presented with mild muscle weakness of the neck and symmetrical proximal parts of the upper and lower limbs. Laboratory tests, needle electromyography, and a muscle biopsy revealed inflammatory myopathy with an apparent clinical classification of polymyositis and positive findings for anti-PM/Scl-75 antibody. This antibody is rare among Japanese populations, and most Japanese patients with the antibody are not classified with the inflammatory myopathy seen in polymyositis. The muscle biopsy also showed marked necrotic and regenerative fibers. We need to collectively investigate patients with the potential to develop this disease, and to identify any unique characteristics for Asian populations, including Japanese.
Collapse
Affiliation(s)
- Yuki Nakamura
- Department of Neurology, Sapporo Kosei General Hospital, Japan
| | - Rei Miyanaga
- Department of Neurology, Sapporo Kosei General Hospital, Japan
| | | | - Shun Shimohama
- Department of Neurology, Sapporo Medical University School of Medicine, Japan
| |
Collapse
|
48
|
Cluster Analysis Using Anti–Aminoacyl-tRNA Synthetases and SS-A/Ro52 antibodies in Patients With Polymyositis/Dermatomyositis. J Clin Rheumatol 2019; 25:246-251. [DOI: 10.1097/rhu.0000000000000836] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
49
|
Lundstrom ZT, Pennington KM, Braun CM. 57-Year-Old Woman With Dyspnea and Rash. Mayo Clin Proc 2019; 94:1079-1083. [PMID: 31171118 DOI: 10.1016/j.mayocp.2018.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/15/2018] [Accepted: 09/19/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Zachary T Lundstrom
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Kelly M Pennington
- Resident in Pulmonary and Critical Care Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Cassandra M Braun
- Advisor to residents and Consultant in Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
| |
Collapse
|
50
|
Horiike Y, Suzuki Y, Fujisawa T, Yasui H, Karayama M, Hozumi H, Furuhashi K, Enomoto N, Nakamura Y, Inui N, Ogawa N, Suda T. Successful classification of macrophage-mannose receptor CD206 in severity of anti-MDA5 antibody positive dermatomyositis associated ILD. Rheumatology (Oxford) 2019; 58:2143-2152. [DOI: 10.1093/rheumatology/kez185] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/08/2019] [Indexed: 12/30/2022] Open
Abstract
Abstract
Objectives
Macrophage-mannose receptor, CD206, is a marker of alternatively activated macrophages. Activated macrophages play key roles in DM. Interstitial lung disease (ILD) is a leading cause of mortality in patients with DM/clinically amyopathic DM (CADM). In particular, patients with the anti-melanoma differential gene 5 antibody (MDA5) frequently develop fatal rapid progressive ILD. This study aimed to evaluate the clinical implications of alternatively activated macrophages in patients with CADM/DM-ILD with anti-MDA5 antibody (MDA5-CADM/DM-ILD).
Methods
We measured serum concentrations of soluble CD206 (sCD206) in 33 patients with MDA5-CADM/DM-ILD and 36 age- and sex-matched control subjects. Expression levels of CD206 in the lungs from MDA5-CADM/DM-ILD were also examined.
Results
Patients with MDA5-CADM/DM-ILD had higher levels of sCD206 than those in controls (P < 0.0001). Of the 33 patients, 10 MDA5-CADM/DM-ILD patients developed fatal respiratory failure. Concentrations of sCD206 in patients with fatal ILD cases were significantly higher than those in the survivors, and increased sCD206 levels were associated with a higher mortality rate (Log-rank test, P = 0.0009). Age- and gender-adjusted logistic regression analyses showed that sCD206 was an independent prognostic factor for MDA5-CADM/DM-ILD. Importantly, assessment by sCD206 together with PaO2 successfully divided into three groups by their prognosis (P < 0.005, respectively). Pathological analyses showed accumulations of CD206-positive macrophages in lungs from the fatal case rather than those in the non-fatal cases.
Conclusions
Levels of serum sCD206 are increased in MDA5-CADM/DM-ILD and associated with poor prognosis. sCD206 is a potential biomarker to predict the severity of MDA5-CADM/DM-ILD.
Collapse
Affiliation(s)
- Yasuoki Horiike
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Yuzo Suzuki
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Hideki Yasui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Masato Karayama
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Hironao Hozumi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Kazuki Furuhashi
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Noriyuki Enomoto
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Yutaro Nakamura
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Naoki Inui
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Noriyoshi Ogawa
- Third Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu,Japan
| |
Collapse
|