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Lemmer D, Ruck T, Schänzer A, Triantafyllias K, Zeng R, Hasseli-Fräbel R. [Idiopathic inflammatory myopathies : An interdisciplinary challenge]. Z Rheumatol 2024:10.1007/s00393-024-01523-w. [PMID: 38864855 DOI: 10.1007/s00393-024-01523-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 06/13/2024]
Abstract
Idiopathic inflammatory myopathies (IIM) are rare diseases (incidence 1:100,000) with a wide range of clinical symptoms and manifestations. Typical indicators of IIM are proximally emphasized muscle weakness and myalgias, which are usually accompanied by elevated creatine kinase levels and muscle atrophy. The autoantibody diagnostics separate IIM into different entities, which are each associated with a typical risk of organ manifestations and the occurrence of tumors. The IIM represents an interdisciplinary challenge and the diagnostics and treatment require the involvement of several disciplines including rheumatology, neurology, neuropathology, dermatology and pneumology. An accurate diagnosis and careful tumor screening are essential because of the association between certain subgroups of IIM and the occurrence of malignant tumors.
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Affiliation(s)
- Dana Lemmer
- Abteilung für Rheumatologie, Klinische Immunologie und Osteologie, Immanuel Krankenhaus Berlin, Berlin, Deutschland
| | - Tobias Ruck
- Klinik für Neurologie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Anne Schänzer
- Institut für Neuropathologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - Konstantinos Triantafyllias
- Rheumazentrum Rheinland-Pfalz, Bad Kreuznach, Deutschland
- I. Medizinische Klinik, Rheumatologie und klinische Immunologie, Johannes Gutenberg Universitätsmedizin Mainz, Mainz, Deutschland
| | - Rachel Zeng
- Klinik für Neurologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Rebecca Hasseli-Fräbel
- Medizinische Klinik D, Sektion für Rheumatologie und Klinische Immunologie, Abteilung für Translationale Rheumatologie und Immunologie, Institut für Muskuloskelettale Medizin (IMM), Universitätsklinikum Münster, Münster, Deutschland.
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Ouazahrou K, El Bakkouri J, Souali M, Jeddane L, Mokhantar K, Errami A, El Kabli H, Bousfiha AA, Echchilali K. Clinical and serological correlation of systemic sclerosis in Moroccan patients. Rheumatol Adv Pract 2023; 7:rkad036. [PMID: 37091295 PMCID: PMC10115467 DOI: 10.1093/rap/rkad036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/22/2023] [Indexed: 04/05/2023] Open
Abstract
Objective SSc is a CTD characterized by excessive fibrosis of the skin and internal organs, along with microvascular damage, and is often associated with typical autoantibodies. The aim of this study was to analyse the correlation between specific autoantibody profiles, clinical and paraclinical features in Moroccan patients with SSc. Methods We analysed the presence of specific autoantibodies in 46 SSc patients using IIF on HEp-2 cells and immunodot. We then correlated the types of autoantibodies with clinical and laboratory manifestations. Results Among our patients, 86.9% were females. The mean age of patients at diagnosis was 50.21 years, with an average delay to diagnosis of 5 years. The main clinical manifestations found were RP (89.2%), sclerodactyly (84.8%), proximal scleroderma (67.4%), gastrointestinal involvement (50%) and interstitial lung disease (30.4%). According to the specific autoantibody profile, 14 patients were anti-topo I positive (30.4%), 8 anti-RNP (68 kDa/A/C) positive (17.4%) and 6 anti-RNA polymerase III positive (13%). We found a significant association of anti-RNA polymerase III with sclerodactyly and pulmonary arterial hypertension (P < 0.05). We also found an association between anti-topo I and interstitial lung disease in 30.4% of patients. There was no significant association between the positivity for the autoantibodies and other diagnosed clinical manifestations. Conclusion Some clinical manifestations of SSc might be positively correlated with the presence of specific autoantibodies. Environmental factors, ethnicity and gene interaction might also influence this correlation.
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Affiliation(s)
- Kaoutar Ouazahrou
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Jalila El Bakkouri
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Immunology Laboratory, IbnRochd University Hospital Center, Casablanca, Morocco
| | - Manal Souali
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Leila Jeddane
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Khaoula Mokhantar
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Abderrahmane Errami
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Hassan El Kabli
- Internal Medicine Department, IbnRochd University Hospital Center, Casablanca, Morocco
| | - Ahmed Aziz Bousfiha
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Clinical Immunology Unit P1, IbnRochd University Hospital Center, Mother and Child El Harouchi Hospital, Casablanca, Morocco
| | - Khadija Echchilali
- Laboratory of Clinical Immunology, Inflammation and Allergy, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Internal Medicine Department, IbnRochd University Hospital Center, Casablanca, Morocco
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Zhang X, Zhang H, Zhao J, Li Y, Wang H, Li C. Diagnostic accuracy and predictive value of autoantibody profiles in patients with systemic sclerosis: a single-center study. Clin Rheumatol 2023; 42:1297-1306. [PMID: 36604358 DOI: 10.1007/s10067-022-06487-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine diagnostic accuracy and evaluate the predictive value of autoantibody profiles in patients with systemic sclerosis (SSc). METHODS A total of 140 patients with SSc (125 female, mean age 54.2 ± 14.2 years) were analyzed by a multiplex line immunoassay (Euroimmun) for autoantibodies against 12 SSc-related antigens. Associations between the presence of the autoantibodies and demographic clinical manifestations of patients with SSc were investigated. RESULTS The sensitivity and specificity of this assay were as follows: 32.9% and 99.4% for anti-Scl-70, 29.3% and 88.9% for anti-CENP A, 28.6% and 87.8% for anti-CENP B, 7.1% and 97.8% for anti-RP11, 5.7% and 100% for anti-RP155, 2.9% and 99.4% for anti-NOR 90, 2.9% and 98.9% for anti-Th/To, 1.4% and 96.7% for anti-PM-Scl-100, 5.0% and 98.3% for anti-PM-Scl-75, and 2.9% and 97.2% for anti-Ku, respectively. Anti-Scl-70 was significantly associated with sine scleroderma (P = 0.003), digital ulcers (P = 0.047), and Raynaud's phenomenon as the first clinical manifestation of onset (P = 0.017). SSc-ILD was more common in patients with anti-Scl-70 (P = 0.029) and less frequent in patients with anti-CENP A (P < 0.001) and anti-CENP B (P < 0.001). There was a significant association between PAH with anti-CENP A (P = 0.008) and anti-CENP B (P = 0.025). Renal involvement was significantly related to anti-NOR90 (P = 0.026) and anti-Th/To (P = 0.026). CONCLUSIONS This study confirmed the important role of autoantibodies in accurately diagnosing SSc. The autoimmune profile of patients with SSc was related to specific disease manifestations. Key Points • Autoantibody profiles were useful for diagnosing SSc and predicting clinical features of patients.
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Affiliation(s)
- Xiaoying Zhang
- Department of Rheumatology and Immunology, Peking University People's Hospital, No.11 Xizhimen South St., Beijing, 100044, China
| | - Huijuan Zhang
- Department of Rheumatology, She Xian Hospital, Handan, Hebei Province, China
| | - Jing Zhao
- Department of Rheumatology and Immunology, Peking University People's Hospital, No.11 Xizhimen South St., Beijing, 100044, China
| | - Yun Li
- Department of Rheumatology and Immunology, Peking University People's Hospital, No.11 Xizhimen South St., Beijing, 100044, China
| | - Hongyan Wang
- Department of Rheumatology and Immunology, Peking University People's Hospital, No.11 Xizhimen South St., Beijing, 100044, China
| | - Chun Li
- Department of Rheumatology and Immunology, Peking University People's Hospital, No.11 Xizhimen South St., Beijing, 100044, China.
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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.
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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.
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Satoh M, Ceribelli A, Hasegawa T, Tanaka S. Clinical Significance of Antinucleolar Antibodies: Biomarkers for Autoimmune Diseases, Malignancies, and others. Clin Rev Allergy Immunol 2022; 63:210-239. [PMID: 35258843 DOI: 10.1007/s12016-022-08931-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2022] [Indexed: 01/13/2023]
Abstract
Nucleolar staining is one of the standard patterns in immunofluorescence antinuclear antibodies (ANA), seen in 5-9% of ANA in various conditions. Antinucleolar antibodies (ANoA) are classified into 3 patterns in the International Consensus on ANA Patterns (ICAP) classification; AC-8 homogeneous pattern, AC-9 clumpy pattern, and AC-10 punctate pattern. Specificities known to show AC-8 include anti-Th/To, -PM-Scl, -nucleophosmin/B23, -nucleolin/C23, -No55, and others. AC-9 is seen by anti-fibrillarin/U3RNP and AC-10 by anti-RNA polymerase I and hUBF/NOR-90. ANoA has been classically known to be associated with scleroderma (SSc) and the characterization of nucleolar antigens identified several autoantigens recognized by SSc autoantibodies. The clinical association of anti-Th/To, PM-Scl, fibrillarin/U3RNP, and RNA polymerase I with SSc or SSc-overlap syndrome is well established, and commercial assays are developed. Anti-hUBF/NOR90, nucleophosmin/B23, and nucleolin/C23 are known for decades and reported in systemic autoimmune rheumatic diseases (SARDs), malignancies, graft versus host disease (GVHD), and others; however, their clinical significance remains to be established.
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Affiliation(s)
- Minoru Satoh
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, 1-1 Isei-gaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
| | - Angela Ceribelli
- Division of Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano (Milan), 20089, Italy
- Department of Biomedical Sciences, Humanitas University, Via A. Manzoni 56, Pieve Emnuele (Milan), 20089, Italy
| | - Tomoko Hasegawa
- Department of Clinical Nursing, School of Health Sciences, University of Occupational and Environmental Health, 1-1 Isei-gaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Shin Tanaka
- Department of Human, Information and Sciences, School of Health Sciences, University of Occupational and Environmental Health, 1-1 Isei-gaoka, Yahata-nishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan
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Breillat P, Mariampillai K, Legendre P, Martins P, Dunogue B, Charuel JL, Miyara M, Goulvestre C, Paule R, Vanquaethem H, Ackermann F, Benveniste O, Nunes H, Mouthon L, Allenbach Y, Uzunhan Y. Anti-PM-Scl antibodies positive patients encompass three different groups with distinct prognosis. Rheumatology (Oxford) 2022; 62:1467-1475. [PMID: 36063462 DOI: 10.1093/rheumatology/keac508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/03/2022] [Accepted: 08/23/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To help identify homogeneous subgroups among patients with anti-polymyositis-scleroderma-antibodies (PM-Scl-Abs) positive auto-immune diseases regardless of diagnostic classifications. METHODS This multicentric (four hospitals) retrospective study collected all consecutive patients (from 2011 to 2021) with positive testing for anti-PM-Scl-Abs in a context of connective tissue disease. Subgroups of patients with similar clinico-biological phenotypes were defined using unsupervised multiple correspondence analysis and hierarchical clustering analysis of the features recorded in the first year of follow-up. RESULTS One hundred and forty-two patients with anti-PM-Scl-Abs were evaluated and 129 patients were included in the clustering analysis and divided into 3 clusters. Cluster n°1 (n = 47) included patients with frequent skin thickening, digestive involvement and interstitial lung disease (ILD) with Non Specific Interstitial Pneumonia (NSIP). They were more likely to develop progressive fibrosing ILD. Cluster n°2 (n = 36) included patients who all featured NSIP with frequent Organizing pneumonia associated pattern and mechanic's hands. This subgroup had increased risk of relapse and ILD was characterized by a good functional outcome. Cluster n°3 (n = 46) was characterized by predominant or isolated musculoskeletal involvement and frequently matched undifferentiated connective tissue disease (UCTD) criteria. Although very frequent among Anti PM-Scl-Abs positive patients, muscle involvement was less discriminating compared with skin thickening and ILD pattern to classify patients into subgroups. CONCLUSION Anti-PM-Scl-Abs associated auto-immune diseases are segregated into 3 subgroups with distinct clinical phenotype and outcomes. Skin thickening and NSIP are determinant predictors in segregation of theses populations.
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Affiliation(s)
- Paul Breillat
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France.,Sorbonne Université, Paris, France
| | - Kuberaka Mariampillai
- Sorbonne Université, INSERM, Association Institut de Myologie, Centre de Recherche en Myologie, UMRS 974, Paris, France
| | - Paul Legendre
- Département de Médecine Interne Hôpital Foch, Suresnes, France
| | - Pauline Martins
- Département de Médecine Interne, Hôpitaux La Rochelle Ré Aunis, La Rochelle, France
| | - Bertrand Dunogue
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France
| | - Jean Luc Charuel
- Département d'Immunologie, Laboratoire d'immunochimie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Makoto Miyara
- Département d'Immunologie, Laboratoire d'immunochimie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Claire Goulvestre
- Laboratoire d'immunologie, Groupe Hospitalier Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Romain Paule
- Département de Médecine Interne Hôpital Foch, Suresnes, France
| | - Helene Vanquaethem
- Clinique médicale, hôpital d'instruction des armées de Bégin, Saint-Mandé, France
| | - Felix Ackermann
- Département de Médecine Interne Hôpital Foch, Suresnes, France
| | - Olivier Benveniste
- Sorbonne Université, INSERM, Association Institut de Myologie, Centre de Recherche en Myologie, UMRS 974, Paris, France.,Département de Médecine Interne et Immunologie Clinique, Centre de Référence Maladies Neuro-Musculaires, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Hilario Nunes
- Département de Pneumologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, INSERM U1272, Université Sorbonne Paris Nord, Bobigny, France
| | - Luc Mouthon
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Centre de Référence pour les Maladies Auto-immunes Rares, Paris, France
| | - Yves Allenbach
- Sorbonne Université, INSERM, Association Institut de Myologie, Centre de Recherche en Myologie, UMRS 974, Paris, France.,Département de Médecine Interne et Immunologie Clinique, Centre de Référence Maladies Neuro-Musculaires, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Yurdagul Uzunhan
- Département de Pneumologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, INSERM U1272, Université Sorbonne Paris Nord, Bobigny, France
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El-Banna G, Fiorentino D. Update on Cutaneous Signs to Assist in the Diagnosis of Dermatomyositis. Curr Rheumatol Rep 2022; 24:156-165. [PMID: 35404005 DOI: 10.1007/s11926-022-01070-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Dermatomyositis (DM) is a heterogeneous idiopathic inflammatory myopathy that can be challenging to diagnose. Learning about the cutaneous manifestations in DM can assist with prompt diagnosis as well as subgroup classification. This review highlights recent data regarding cutaneous signs in DM and their associations with myositis-specific antibodies (MSAs). RECENT FINDINGS Several novel DM skin signs have recently been reported. Novel and confirmatory data have helped to define more clearly the associations between various cutaneous manifestations and MSAs. Awareness of the diverse cutaneous phenotypes can help with the timely diagnosis of DM. As some MSAs are associated with atypical skin features and/or characteristic patterns of clinical findings, knowledge of these associations can help clinicians to recognize DM patients. Understanding how the prevalence and presentation of various cutaneous signs differ among ethnically diverse patients is a high priority for further study.
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Affiliation(s)
- Ghida El-Banna
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway, Pavilion C #C-234, Redwood City, CA, 94063, USA
| | - David Fiorentino
- Department of Dermatology, Stanford University School of Medicine, 450 Broadway, Pavilion C #C-234, Redwood City, CA, 94063, USA.
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Halilu F, Christopher-Stine L. Myositis-specific Antibodies: Overview and Clinical Utilization. RHEUMATOLOGY AND IMMUNOLOGY RESEARCH 2022; 3:1-10. [PMID: 36467022 PMCID: PMC9524809 DOI: 10.2478/rir-2022-0001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 01/28/2022] [Indexed: 05/25/2023]
Abstract
Purpose of review-To review autoantibodies associated with different subtypes of idiopathic inflammatory myopathy (IIM) and their clinical applications. IIM are a heterogenous group of autoimmune disorders characterized by muscle weakness, cutaneous features, and internal organ involvement. The diagnosis and classification, which is often challenging, is made using a combination of clinical features, muscle enzyme levels, imaging, and biopsy. The landmark discoveries of novel autoantibodies specific to IIM subtypes have been one of the greatest advancements in the field of myositis. The specificity of these autoantibodies has simplified the diagnostic algorithm of IIM with their heterogenous presentation and outdated the earlier diagnostic criteria. Myositis-specific antibodies (MSAs) have improved diagnostics, clinical phenotyping, and prognostic stratification of the subtypes of IIMs. Furthermore, the levels of certain MSAs correlate with disease activity and muscle enzyme levels such that titers may be able to be used to predict disease course and treatment response.
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Affiliation(s)
- Fatima Halilu
- Department of Medicine, Greater Baltimore Medical Center, Towson, MD, USA
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9
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Ge Y, Shu X, He L, Li C, Lu X, Wang G. Interstitial Lung Disease Is a Major Characteristic of Patients Who Test Positive for Anti-PM/Scl Antibody. Front Med (Lausanne) 2022; 8:778211. [PMID: 35118087 PMCID: PMC8804089 DOI: 10.3389/fmed.2021.778211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Objective This study aimed to analyze the clinical features of anti-PM/Scl antibodies in Chinese patients. Method We reviewed the clinical data of anti-PM/Scl antibody-positive patients, including their long-term follow-up. Results A total of 30 patients carried anti-PM/Scl antibodies, 21 (70%) were females, and the mean age was 55.4 years, 15 (50%) and 10 (33.3%) patients were positive for anti-PM/Scl-75 and anti-PM/Scl-100, respectively. Fifteen cases (50%) were diagnosed as inflammatory myopathy, namely, 11 dermatomyositis (DM) and 4 polymyositis (PM). Five (16.7%) patients were diagnosed with overlap syndrome, and only one (3.3%) was diagnosed as systemic sclerosis. The other 9 (30%) patients were classified as undifferentiated connective tissue disease. Twenty-six (86.7%) had interstitial lung disease (ILD) and was the sole manifestation in 8 (26.7%) patients, 15 (58.0%) showed non-specific interstitial pneumonia based on high-resolution CT or lung biopsy. The majority of patients (95%) with mild and moderate groups on basis of pulmonary function tests. Compared to the anti-PM/Scl-100 group, the occurrence of clinical characteristics was not significantly different from the anti-PM/Scl-75 group, except the levels of C-reactive protein and erythrocyte sedimentation rate in the anti-PM/Scl-75 antibody-positive group were higher (p < 0.05). All patients with positive Ro-52 antibodies had ILD and were more likely to develop skin rash in the group with Ro-52 (p = 0.024). With a follow-up of the present cohort, 70.8% improved with treatment, but 16.7% of patients are easy to relapse. Conclusion The anti-PM/Scl antibody occurred frequently in DM/PM patients, ILD was the major clinical feature, especially in patients combined with Ro-52. Some patients may complicate with ILD alone without extrapulmonary manifestations. Anti-PM/Scl antibodies positive patients were responsive to treatment.
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10
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Iniesta Arandia N, Espinosa G, Guillén Del Castillo A, Tolosa-Vilella C, Colunga-Argüelles D, González de Echávarri Pérez de Heredia C, Lledó GM, Comet LS, Ortego-Centeno N, Vargas Hito JA, Rubio-Rivas M, Freire M, Ríos-Blanco JJ, Rodríguez-Carballeira M, Trapiella-Martínez L, Fonollosa-Pla V, Simeón-Aznar CP. Anti-Polymyositis/Scl Antibodies in Systemic Sclerosis: Clinical Associations in a Multicentric Spanish Cohort and Review of the Literature. J Clin Rheumatol 2022; 28:e180-e188. [PMID: 33938499 DOI: 10.1097/rhu.0000000000001676] [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: 10/21/2022]
Abstract
OBJECTIVES To assess the clinical profile of patients with anti-polymyositis/Scl (PM/Scl) antibodies in a cohort of Spanish patients with systemic sclerosis. METHODS From the Spanish Scleroderma Study Group database, we selected patients in whom PM/Scl antibodies had been tested. We compared demographic, clinical, laboratory, and survival data between patients with and without PM/Scl antibodies. RESULTS Seventy-two of 947 patients (7.6%) tested positive for PM/Scl antibodies. Patients with PM/Scl antibodies presented initially with more puffy fingers and arthralgias but less Raynaud phenomenon. Regarding cumulative manifestations, myositis and arthritis were more prevalent in patients with PM/Scl antibodies, as well as pulmonary fibrosis. On the contrary, patients with PM/Scl antibodies had less pulmonary hypertension. No difference in terms of survival at 5 and 10 years was noticed between the 2 groups. CONCLUSIONS In systemic sclerosis patients from Spain, PM/Scl antibodies are associated with a distinct clinical profile. However, PM/Scl antibodies did not influence survival.
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Affiliation(s)
- Nerea Iniesta Arandia
- From the Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Gerard Espinosa
- From the Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain
| | | | - Carles Tolosa-Vilella
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Catalonia
| | | | | | - Gema M Lledó
- From the Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Luis Sáez Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza
| | - Norberto Ortego-Centeno
- Department of Internal Medicine, Hospital Campus de la Salud, Complejo Universitario de Granada
| | | | - Manuel Rubio-Rivas
- Department of Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona
| | - Mayka Freire
- Department of Internal Medicine, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña
| | | | | | | | - Vicent Fonollosa-Pla
- Department of Internal Medicine, Hospital Vall d'Hebron, Barcelona, Catalonia, Spain
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11
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Saito S, Endo Y, Nishio M, Uchiyama A, Uehara A, Toki S, Yasuda M, Ishikawa O, Muro Y, Motegi SI. Anti-polymyositis/Scl antibody-positive overlap syndrome of diffuse cutaneous systemic sclerosis, dermatomyositis, systemic lupus erythematosus, and antiphospholipid syndrome. J Dermatol 2021; 49:294-298. [PMID: 34730249 DOI: 10.1111/1346-8138.16219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/04/2021] [Accepted: 10/20/2021] [Indexed: 11/28/2022]
Abstract
A 37-year-old Japanese man with a 3-year history of diffuse cutaneous systemic sclerosis was admitted to our hospital with high fever, arthralgia, myalgia, and muscle weakness. A physical examination revealed facial erythema, Gottron's sign, and mechanic's hands in addition to skin sclerosis. Laboratory data revealed significantly elevated levels of creatine kinase and decreased complement. Anti-RNP, anti-Smith, anti-DNA, anti-β2 -glycoprotein 1, anti-polymyositis (PM)/Scl75, and anti-PM/Scl100 antibodies were detected. He also had urinary protein, interstitial lung disease, pericarditis, multifocal cerebral infarctions, and leukoencephalopathy. Thus, a diagnosis of overlap syndrome of diffuse cutaneous systemic sclerosis, dermatomyositis, and systemic lupus erythematosus with antiphospholipid syndrome was made. Because of the intractable course, he was treated with multiple immunosuppressive and immunomodulatory drugs, including three rounds of 1000 mg methylprednisolone pulse therapy. This is the first case report of anti-PM/Scl antibody-positive overlap syndrome of three major connective tissue diseases.
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Affiliation(s)
- Shintaro Saito
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yukie Endo
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Mayu Nishio
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akihiko Uchiyama
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Akihito Uehara
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Sayaka Toki
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masahito Yasuda
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Osamu Ishikawa
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yoshinao Muro
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sei-Ichiro Motegi
- Department of Dermatology, Gunma University Graduate School of Medicine, Maebashi, Japan
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12
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Nishida T, Nakano K, Satoh M, Fukuyo S, Akashi K, Tanaka Y. A Japanese Patient with Anti-PM/Scl and Centromere Antibody-Positive Scleroderma-Amyopathic Dermatomyositis Overlap Syndrome Who Developed Renal Crisis. Mod Rheumatol Case Rep 2021; 6:69-74. [PMID: 34506625 DOI: 10.1093/mrcr/rxab025] [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: 06/28/2021] [Revised: 08/09/2021] [Accepted: 08/16/2021] [Indexed: 11/13/2022]
Abstract
Anti-PM/Scl antibodies are associated with the overlap syndrome of systemic sclerosis and dermatomyositis/polymyositis (SSc-DM/PM), and are found in 50% of SSc-DM/PM cases in Europe and the United States, whereas they are rare in Japan. We report a case of an 80-year-old Japanese female with SSc-amyopathic dermatomyositis (ADM) overlap syndrome, who developed scleroderma renal crisis (SRC), a complication of SSc. She had positive antinuclear antibodies in a discrete-speckled and nucleolar pattern and anticentromere antibodies and anti-PM/Scl antibodies were confirmed by ELISA and immunoprecipitation, respectively. The incidence rate of SRC in SSc patients varies significantly depending on the specificity of autoantibodies, with the highest incidence of ~50% in anti-RNA polymerase III antibody positive patients, followed by ~10% in anti-PM/Scl and lower incidence of 0.45% in anticentromere antibody-positive cases. Anti-PM/Scl antibodies are uncommon in Japanese patients presumably due to its strong association with certain HLA haplotype that is rare in Japanese. Clinical significance of anti-PM/Scl antibodies in Japanese patients will need to be clarified with accumulation of cases in future studies.
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Affiliation(s)
- Tomoya Nishida
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.,Department of Medicine and Biosystemic Science, Kyushu University Faculty of Medicine, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.,Department of Rheumatology, Kawasaki Medical School, Japan
| | - Minoru Satoh
- Department of Clinical Nursing, University of Occupational and Environmental Health, Japan
| | - Shunsuke Fukuyo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Koichi Akashi
- Department of Medicine and Biosystemic Science, Kyushu University Faculty of Medicine, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan
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13
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Yamashita Y, Yamano Y, Muro Y, Ogawa-Momohara M, Takeichi T, Kondoh Y, Akiyama M. Clinical significance of anti-NOR90 antibodies in systemic sclerosis and idiopathic interstitial pneumonia. Rheumatology (Oxford) 2021; 61:1709-1716. [PMID: 34282441 DOI: 10.1093/rheumatology/keab575] [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: 05/06/2021] [Revised: 07/09/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Anti-NOR90 antibodies are usually found in patients with systemic sclerosis (SSc); however, their clinical relevance remains obscure. We developed an enzyme-linked immunosorbent assay (ELISA) for measuring them to investigate the clinical features of patients with anti-NOR90 antibodies. METHODS Serum samples from 1,252 patients with various conditions from Nagoya University Hospital and 244 patients with idiopathic interstitial pneumonia (IIP) from Tosei General Hospital were included. Anti-NOR90 antibodies were assayed by an ELISA using the recombinant protein produced by in vitro transcription/translation. RESULTS Five (0.4%) patients in the Nagoya University Hospital cohort had anti-NOR90 antibodies. One patient with diffuse cutaneous SSc, 3 with limited cutaneous SSc, and 1 with Raynaud's disease were positive for anti-NOR90 antibodies. Anti-NOR90 antibodies were found more frequently in patients with systemic scleroderma-spectrum disorders (SSDs) than without SSDs (5/316 vs. 0/936, P<0.00101) and were found more frequently in patients with SSc than without SSc (4/249 vs. 0/528, P<0.0104) in the systemic autoimmune rheumatic diseases cohort. Three of the 4 anti-NOR90-positive SSc patients had interstitial lung disease (ILD), and 2 of those 4 had cancer. Three (1.2%) patients in the Tosei General Hospital cohort had anti-NOR90 antibodies. All 3 of the anti-NOR90-positive IIP patients had gastrointestinal tract involvement, and 2 of those 3 had cancer or skin lesions observed in SSc. CONCLUSIONS Although anti-NOR90 antibodies are rarely found in clinics, our ELISA is useful for their detection. Further studies are needed to confirm the association of anti-NOR90 antibodies with ILD and cancer in SSc and IIP patients.
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Affiliation(s)
- Yuta Yamashita
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan
| | - Yasuhiko Yamano
- Department of Respiratory and Allergic Medicine, Tosei General Hospital, Seto, Aichi 489-8642, Japan
| | - Yoshinao Muro
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan
| | - Mariko Ogawa-Momohara
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan
| | - Takuya Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan
| | - Yasuhiro Kondoh
- Department of Respiratory and Allergic Medicine, Tosei General Hospital, Seto, Aichi 489-8642, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan
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14
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Aguilar-Vazquez A, Chavarria-Avila E, Pizano-Martinez O, Ramos-Hernandez A, Andrade-Ortega L, Rubio-Arellano ED, Vazquez-Del Mercado M. Geographical Latitude Remains as an Important Factor for the Prevalence of Some Myositis Autoantibodies: A Systematic Review. Front Immunol 2021; 12:672008. [PMID: 33968081 PMCID: PMC8100663 DOI: 10.3389/fimmu.2021.672008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
The idiopathic inflammatory myopathies (IIM) are characterized by muscular weakness, cutaneous manifestations, muscle damage revealed by increase of muscular enzymes, muscle biopsy, electromyography and changes on magnetic resonance imaging. However, the hallmark of these IIM, is the development of myositis specific antibodies (MSA) or myositis associated antibodies (MAA). The theories about their presence in the serum of IIM is not known. Some studies have suggested that some of these MSA, such as anti-Mi-2 increases according to the intensity of UV radiation. There is scarce information about the environmental factors that might contribute in order to be considered as triggering factors as UV radiation might be. In this review, we analyzed the reported prevalence of MSAs and MAAs regarding to their geographical location and the possible relation with UV radiation. We collected the prevalence data of fifteen MSA and thirteen MAA from 22 countries around the world and we were able to observe a difference in prevalence between countries and continents. We found differences in anti-PL7, anti-Ro52, anti-La and anti-Ku prevalence according to UV radiation level. Otherwise, we observed that anti-Mi-2 prevalence increases near to the Equator meanwhile anti-MJ/NXP2 and anti-ARS prevalence had an opposite behavior increasing their prevalence in the geographical locations farther to the Equator. Our results highlighted the importance to include the UV radiation and other environmental factors in IIM studies, in order to clarify its association with MSA and MAA prevalence as well as its possible role in the immunopathogenesis of these diseases.
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Affiliation(s)
- Andrea Aguilar-Vazquez
- Centro Universitario de Ciencias de la Salud, Doctorado en Ciencias Biomédicas, Universidad de Guadalajara, Guadalajara, Mexico.,Centro Universitario de Ciencias de la Salud, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Universidad de Guadalajara, Guadalajara, Mexico
| | - Efrain Chavarria-Avila
- Centro Universitario de Ciencias de la Salud, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Universidad de Guadalajara, Guadalajara, Mexico.,Centro Universitario de Ciencias de la Salud, Departamento de Disciplinas Filosófico, Metodológicas e Instrumentales, Universidad de Guadalajara, Guadalajara, Mexico.,Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT, Guadalajara, Mexico
| | - Oscar Pizano-Martinez
- Centro Universitario de Ciencias de la Salud, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Universidad de Guadalajara, Guadalajara, Mexico.,Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT, Guadalajara, Mexico.,Centro Universitario de Ciencias de la Salud, UDG-CA 703 Inmunología y Reumatología, Universidad de Guadalajara, Guadalajara, Mexico
| | - Alejandra Ramos-Hernandez
- Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT, Guadalajara, Mexico
| | - Lilia Andrade-Ortega
- Departamento de Reumatología Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Ciudad de México, Mexico
| | - Edy-David Rubio-Arellano
- Centro Universitario de Ciencias de la Salud, Departamento de Fisiología, Universidad de Guadalajara, Guadalajara, Mexico
| | - Monica Vazquez-Del Mercado
- Centro Universitario de Ciencias de la Salud, Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), Universidad de Guadalajara, Guadalajara, Mexico.,Hospital Civil Dr. Juan I. Menchaca, División de Medicina Interna, Servicio de Reumatología 004086, PNPC CONACyT, Guadalajara, Mexico.,Centro Universitario de Ciencias de la Salud, UDG-CA 703 Inmunología y Reumatología, Universidad de Guadalajara, Guadalajara, Mexico.,Centro Universitario de Ciencias de la Salud, Departamento de Biología Molecular y Genómica, Universidad de Guadalajara, Guadalajara, Mexico
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15
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Fujisawa T. Management of Myositis-Associated Interstitial Lung Disease. ACTA ACUST UNITED AC 2021; 57:medicina57040347. [PMID: 33916864 PMCID: PMC8065549 DOI: 10.3390/medicina57040347] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/01/2021] [Accepted: 04/02/2021] [Indexed: 11/30/2022]
Abstract
Idiopathic inflammatory myopathies, including polymyositis (PM), dermatomyositis (DM), and clinically amyopathic DM (CADM), are a diverse group of autoimmune diseases characterized by muscular involvement and extramuscular manifestations. Interstitial lung disease (ILD) has major pulmonary involvement and is associated with increased mortality in PM/DM/CADM. The management of PM-/DM-/CADM-associated ILD (PM/DM/CADM-ILD) requires careful evaluation of the disease severity and clinical subtype, including the ILD forms (acute/subacute or chronic), because of the substantial heterogeneity of their clinical courses. Recent studies have highlighted the importance of myositis-specific autoantibodies’ status, especially anti-melanoma differentiation-associated gene 5 (MDA5) and anti-aminoacyl tRNA synthetase (ARS) antibodies, in order to evaluate the clinical phenotypes and treatment of choice for PM/DM/CADM-ILD. Because the presence of the anti-MDA5 antibody is a strong predictor of a worse prognosis, combination treatment with glucocorticoids (GCs) and calcineurin inhibitors (CNIs; tacrolimus (TAC) or cyclosporin A (CsA)) is recommended for patients with anti-MDA5 antibody-positive DM/CADM-ILD. Rapidly progressive DM/CADM-ILD with the anti-MDA5 antibody is the most intractable condition, which requires immediate combined immunosuppressive therapy with GCs, CNIs, and intravenous cyclophosphamide. Additional salvage therapies (rituximab, tofacitinib, and plasma exchange) should be considered for patients with refractory ILD. Patients with anti-ARS antibody-positive ILD respond better to GC treatment, but with frequent recurrence; thus, GCs plus immunosuppressants (TAC, CsA, azathioprine, and mycophenolate mofetil) are often needed in order to achieve favorable long-term disease control. PM/DM/CADM-ILD management is still a therapeutic challenge for clinicians, as evidence-based guidelines do not exist to help with management decisions. A few prospective clinical trials have been recently reported regarding the treatment of PM/DM/CADM-ILD. Here, the current knowledge on the pharmacologic managements of PM/DM/CADM-ILD was mainly reviewed.
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Affiliation(s)
- Tomoyuki Fujisawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu 431-3192, Japan
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16
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Shimizu T, Saito C, Watanabe M, Ishii R, Kawamura T, Nagai K, Fujita A, Kaneko S, Kai H, Morito N, Usui J, Yokosawa M, Kondo Y, Inoue S, Okiyama N, Yamagata K. Anti-PM/Scl Antibody-positive Systemic Sclerosis Complicated by Multiple Organ Involvement. Intern Med 2021; 60:1101-1107. [PMID: 33132335 PMCID: PMC8079901 DOI: 10.2169/internalmedicine.5665-20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 40-year-old Japanese woman developed malignant-phase hypertension complicated by thrombotic microangiopathy, progressing to end-stage renal disease. Five years later, she was diagnosed with pulmonary arterial hypertension and interstitial pneumonia. Despite a lack of overt skin sclerosis, nucleolar staining in our indirect immunofluorescence analysis and nailfold capillaroscopy facilitated the diagnosis of anti-PM/Scl antibody-positive systemic sclerosis. We observed the persistent presence of anti-PM/Scl antibodies throughout the clinical course, suggesting that her kidney disease was scleroderma renal crisis. Anti-PM/Scl antibodies can be associated with multiple organ diseases. Careful attention to a patient's antinuclear antibody pattern and dermatological findings may help clarify the etiology of undiagnosed diseases.
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Affiliation(s)
- Tatsuya Shimizu
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Chie Saito
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Megumi Watanabe
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Ryota Ishii
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Tetsuya Kawamura
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Kei Nagai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Akiko Fujita
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Shuzo Kaneko
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Hirayasu Kai
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Naoki Morito
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Joichi Usui
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
| | - Masahiro Yokosawa
- Department of Rheumatology, Faculty of Medicine, University of Tsukuba, Japan
| | - Yuya Kondo
- Department of Rheumatology, Faculty of Medicine, University of Tsukuba, Japan
| | - Sae Inoue
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Japan
| | - Naoko Okiyama
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Japan
| | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Japan
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17
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Lazzaroni MG, Marasco E, Campochiaro C, DeVries-Bouwstra J, Gonzalez-Perez MI, Rojas-Serrano J, Hachulla E, Zanatta E, Barsotti S, Furini F, Triantafyllias K, Abignano G, Truchetet ME, De Luca G, De Langhe E, Hesselstrand R, Ingegnoli F, Bertoldo E, Smith V, Bellando-Randone S, Poormoghim H, Colombo E, Ceribelli A, Furloni A, Zingarelli S, Cavazzana I, Franceschini F, Del Galdo F, Denton CP, Cavagna L, Distler O, Allanore Y, Airò P. The clinical phenotype of Systemic Sclerosis patients with anti-PM/Scl antibodies: results from the EUSTAR cohort. Rheumatology (Oxford) 2021; 60:5028-5041. [PMID: 33580257 DOI: 10.1093/rheumatology/keab152] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/03/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To evaluate clinical associations of anti-PM/Scl antibodies in patients with Systemic Sclerosis (SSc) in a multicentre international cohort, with particular focus on unresolved issues, including scleroderma renal crisis (SRC), malignancies, and functional outcome of interstitial lung disease (ILD). METHODS (1) Analysis of SSc patients from the EUSTAR database: 144 anti-PM/Scl+ without SSc-specific autoantibodies were compared to 7,202 anti-PM/Scl-, and then to 155 anti-Pm/Scl+ with SSc-specific antibodies. (2) Case-control study: additional data were collected for 165 anti-PM/Scl+ SSc (85 from the EUSTAR registry), and compared to 257 anti-PM/Scl- SSc controls, matched for sex, cutaneous subset, disease duration, and age at SSc onset. RESULTS Patients with isolated anti-PM/Scl positivity, as compared with anti-Pm/Scl-, had higher frequency of muscle involvement, ILD, calcinosis and cutaneous signs of dermatomyositis, but similar frequency of SRC and malignancies (either synchronous with SSc onset or not). The presence of muscle involvement was associated with a more severe disease phenotype. Although very frequent, ILD had a better functional outcome in cases than in controls.In patients with both anti-PM/Scl and SSc-specific antibodies, a higher frequency of typical SSc features than in those with isolated anti-PM/Scl was observed. CONCLUSION The analysis of the largest series of anti-PM/Scl+ SSc patients so far reported helps to delineate a specific clinical subset with muscle involvement, cutaneous dermatomyositis, calcinosis, and ILD characterized by a good functional outcome. SRC and malignancies do not seem to be part of this syndrome.
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Affiliation(s)
- Maria-Grazia Lazzaroni
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Emiliano Marasco
- Division of Rheumatology, Hospital IRCCS Policlinico S. Matteo Foundation of Pavia, University of Pavia, Pavia, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy.,Royal Free Hospital and University College London Medical School, London, UK
| | - Jeska DeVries-Bouwstra
- Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, Netherlands
| | - Montserrat-Ixchel Gonzalez-Perez
- Interstitial Lung Disease and Rheumatology Units, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, México City, México
| | - Jorge Rojas-Serrano
- Interstitial Lung Disease and Rheumatology Units, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, México City, México
| | - Eric Hachulla
- Department of Internal Medicine, University Lille Nord-de-France, Lille, France
| | - Elisabetta Zanatta
- Rheumatology Unit, Department of Medicine-DIMED, University of Padova, Padova, Italy
| | - Simone Barsotti
- Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Federica Furini
- UOC Reumatologia, Azienda Ospedaliero Universitaria S. Anna, University of Ferrara, Ferrara, Italy
| | | | - Giuseppina Abignano
- Leeds Institute of Rheumatic and Musculoskeletal Medicine and NIHR Biomedical Research Centre, Leeds, UK
| | | | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy
| | - Ellen De Langhe
- Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Roger Hesselstrand
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
| | - Francesca Ingegnoli
- Division of Clinical Rheumatology, ASST Pini-CTO; Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milano, Italy
| | - Eugenia Bertoldo
- Rheumatology Unit, Azienda Ospedaliero Universitaria Integrata, Verona, Italy
| | - Vanessa Smith
- Rheumatology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Silvia Bellando-Randone
- Department of Biomedicine, Division of Rheumatology AOUC and Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Hadi Poormoghim
- Scleroderma Study group, Department of Rheumatology. Firoozgar Hospital, Tehran, Iran
| | | | | | - Alessio Furloni
- Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Stefania Zingarelli
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Ilaria Cavazzana
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Franco Franceschini
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.,Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Francesco Del Galdo
- Leeds Institute of Rheumatic and Musculoskeletal Medicine and NIHR Biomedical Research Centre, Leeds, UK
| | | | - Lorenzo Cavagna
- Division of Rheumatology, Hospital IRCCS Policlinico S. Matteo Foundation of Pavia, University of Pavia, Pavia, Italy
| | - Oliver Distler
- Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Yannick Allanore
- Department of Rheumatology, University of Paris, Cochin Hospital and INSERM U1016, Paris, France
| | - Paolo Airò
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
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18
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Muro Y, Ogawa-Momohara M, Takeichi T, Fukaya S, Yasuoka H, Kono M, Akiyama M. Clinical and serological features of dermatomyositis and systemic lupus erythematosus patients with autoantibodies to ADAR1. J Dermatol Sci 2020; 100:82-84. [PMID: 32907776 DOI: 10.1016/j.jdermsci.2020.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/24/2020] [Accepted: 08/16/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Yoshinao Muro
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Mariko Ogawa-Momohara
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shusaku Fukaya
- Division of Rheumatology, Department of Internal Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Hidekata Yasuoka
- Division of Rheumatology, Department of Internal Medicine, Fujita Health University School of Medicine, Aichi, Japan
| | - Michihiro Kono
- Department of Dermatology and Plastic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Masashi Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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19
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Sambataro D, Sambataro G, Pignataro F, Zanframundo G, Codullo V, Fagone E, Martorana E, Ferro F, Orlandi M, Del Papa N, Cavagna L, Malatino L, Colaci M, Vancheri C. Patients with Interstitial Lung Disease Secondary to Autoimmune Diseases: How to Recognize Them? Diagnostics (Basel) 2020; 10:E208. [PMID: 32283744 PMCID: PMC7235942 DOI: 10.3390/diagnostics10040208] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 02/06/2023] Open
Abstract
The diagnostic assessment of patients with Interstitial Lung Disease (ILD) can be challenging due to the large number of possible causes. Moreover, the diagnostic approach can be limited by the severity of the disease, which may not allow invasive exams. To overcome this issue, the referral centers for ILD organized Multidisciplinary Teams (MDTs), including physicians and experts in complementary discipline, to discuss the management of doubtful cases of ILD. MDT is currently considered the gold standard for ILD diagnosis, but it is not often simple to organize and, furthermore, rheumatologists are still not always included. In fact, even if rheumatologic conditions represent a common cause of ILD, they are sometimes difficult to recognize, considering the variegated clinical features and their association with all possible radiographic patterns of ILD. The first objective of this review is to describe the clinical, laboratory, and instrumental tests that can drive a diagnosis toward a possible rheumatic disease. The secondary objective is to propose a set of first-line tests to perform in all patients in order to recognize any possible rheumatic conditions underlying ILD.
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Affiliation(s)
- Domenico Sambataro
- Artroreuma S.R.L., Outpatient clinic of Rheumatology associated with the National Health System Corso S. Vito 53, 95030 Catania, Italy
- Department of Clinical and Experimental Medicine, Internal Medicine Unit, Cannizzaro Hospital, University of Catania, via Messina 829, 95100 Catania, Italy; (L.M.); (M.C.)
| | - Gianluca Sambataro
- Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dept. of Clinical and Experimental Medicine, University of Catania, via S. Sofia 68, pavillon 3 floor 1, 95123 Catania, Italy; (E.F.); (E.M.); (C.V.)
| | - Francesca Pignataro
- Scleroderma clinic, Department of Rheumatology, ASST G. Pini, 20122 Milan, Italy; (F.P.); (N.D.P.)
| | - Giovanni Zanframundo
- Division of Rheumatology, Hospital IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (V.C.); (L.C.)
| | - Veronica Codullo
- Division of Rheumatology, Hospital IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (V.C.); (L.C.)
| | - Evelina Fagone
- Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dept. of Clinical and Experimental Medicine, University of Catania, via S. Sofia 68, pavillon 3 floor 1, 95123 Catania, Italy; (E.F.); (E.M.); (C.V.)
| | - Emanuele Martorana
- Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dept. of Clinical and Experimental Medicine, University of Catania, via S. Sofia 68, pavillon 3 floor 1, 95123 Catania, Italy; (E.F.); (E.M.); (C.V.)
| | - Francesco Ferro
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Martina Orlandi
- Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC, University of Florence, 50139 Florence, Italy;
| | - Nicoletta Del Papa
- Scleroderma clinic, Department of Rheumatology, ASST G. Pini, 20122 Milan, Italy; (F.P.); (N.D.P.)
| | - Lorenzo Cavagna
- Division of Rheumatology, Hospital IRCCS Policlinico S. Matteo Foundation of Pavia, 27100 Pavia, Italy; (G.Z.); (V.C.); (L.C.)
| | - Lorenzo Malatino
- Department of Clinical and Experimental Medicine, Internal Medicine Unit, Cannizzaro Hospital, University of Catania, via Messina 829, 95100 Catania, Italy; (L.M.); (M.C.)
| | - Michele Colaci
- Department of Clinical and Experimental Medicine, Internal Medicine Unit, Cannizzaro Hospital, University of Catania, via Messina 829, 95100 Catania, Italy; (L.M.); (M.C.)
| | - Carlo Vancheri
- Regional Referral Centre for Rare Lung Diseases, A. O. U. “Policlinico-Vittorio Emanuele” Dept. of Clinical and Experimental Medicine, University of Catania, via S. Sofia 68, pavillon 3 floor 1, 95123 Catania, Italy; (E.F.); (E.M.); (C.V.)
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Ogawa-Momohara M, Muro Y, Akiyama M. Overlap of systemic lupus erythematosus and myositis is rare in anti-Ku antibody-positive patients. Ann Rheum Dis 2019; 80:e147. [PMID: 31604706 DOI: 10.1136/annrheumdis-2019-216375] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 09/28/2019] [Indexed: 11/04/2022]
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de Souza FHC, de Araújo DB, Vilela VS, Simões RS, Bernardo WM, Frank TA, da Cunha BM, Shinjo SK. The Brazilian Society of Rheumatology recommendations on investigation and diagnosis of systemic autoimmune myopathies. Adv Rheumatol 2019; 59:42. [PMID: 31601261 DOI: 10.1186/s42358-019-0085-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 09/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This research is recommended by the Myopathy Committee of the Brazilian Society of Rheumatology for the investigation and diagnosis of systemic autoimmune myopathies. BODY: A systematic literature review was performed in the Embase, Medline (PubMed) and Cochrane databases, including studies published until October 2018. PRISMA was used for the review, and the articles were evaluated, based on the Oxford levels of evidence. Ten recommendations were developed addressing different aspects of systemic autoimmune myopathy investigation and diagnosis. CONCLUSIONS The European League Against Rheumatism/ American College of Rheumatology (EULAR/ACR) classification stands out for the diagnosis of systemic autoimmune myopathies. Muscular biopsy is essential, aided by muscular magnetic resonance images and electroneuromyography in complementary research. Analysis of the factors related to prognosis with the evaluation of extramuscular manifestations, and comorbidities and intense investigation regarding differential diagnoses are mandatory.
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Affiliation(s)
| | | | | | - Ricardo Santos Simões
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | | | - Thais Amanda Frank
- Programa Diretrizes da Associação Médica Brasileira (AMB), Brasília, Brazil
| | | | - Samuel Katsuyuki Shinjo
- Disciplina de Reumatologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, 3° andar, sala 3150, Sao Paulo, Cerqueira César, CEP: 01246-903, Brazil.
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22
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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.
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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
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Hamaguchi Y, Kuwana M, Takehara K. Performance evaluation of a line blot assay system for detection of anti‐PM‐Scl antibody in Japanese patients with systemic sclerosis. Int J Rheum Dis 2019; 22:1746-1751. [DOI: 10.1111/1756-185x.13638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Yasuhito Hamaguchi
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences Kanazawa University Kanazawa Japan
| | - Masataka Kuwana
- Department of Allergy and Rheumatology Nippon Medical School Graduate School of Medicine Tokyo Japan
| | - Kazuhiko Takehara
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences Kanazawa University Kanazawa Japan
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24
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Cai C, Anthony DC, Pytel P. A pattern-based approach to the interpretation of skeletal muscle biopsies. Mod Pathol 2019; 32:462-483. [PMID: 30401945 DOI: 10.1038/s41379-018-0164-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 12/19/2022]
Abstract
The interpretation of muscle biopsies is complex and provides the most useful information when integrated with the clinical presentation of the patient. These biopsies are performed for workup of a wide range of diseases including dystrophies, metabolic diseases, and inflammatory processes. Recent insights have led to changes in the classification of inflammatory myopathies and have changed the role that muscle biopsies have in the workup of inherited diseases. These changes will be reviewed. This review follows a morphology-driven approach by discussing diseases of skeletal muscle based on a few basic patterns that include cases with (1) active myopathic damage and inflammation, (2) active myopathic damage without associated inflammation, (3) chronic myopathic changes, (4) myopathies with distinctive inclusions or vacuoles, (5) biopsies mainly showing atrophic changes, and (6) biopsies that appear normal on routine preparations. Each of these categories goes along with certain diagnostic considerations and pitfalls. Individual biopsy features are only rarely pathognomonic. Establishing a firm diagnosis therefore typically requires integration of all of the biopsy findings and relevant clinical information. With this approach, a muscle biopsy can often provide helpful information in the diagnostic workup of patients presenting with neuromuscular problems.
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Affiliation(s)
- Chunyu Cai
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Douglas C Anthony
- Departments of Pathology and Laboratory Medicine, and Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Peter Pytel
- Department of Pathology, University of Chicago, Chicago, IL, USA.
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25
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26
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Wilfong EM, Lentz RJ, Guttentag A, Tolle JJ, Johnson JE, Kropski JA, Kendall PL, Blackwell TS, Crofford LJ. Interstitial Pneumonia With Autoimmune Features: An Emerging Challenge at the Intersection of Rheumatology and Pulmonology. Arthritis Rheumatol 2018; 70:1901-1913. [PMID: 30058242 DOI: 10.1002/art.40679] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 07/24/2018] [Indexed: 01/03/2023]
Abstract
Interstitial lung disease (ILD) remains a cause of significant morbidity and mortality in patients with connective tissue disease (CTD)-associated ILD. While some patients meet clear classification criteria for a systemic rheumatic disease, a subset of patients do not meet classification criteria but still benefit from immunosuppressive therapy. In 2015, the American Thoracic Society and European Respiratory Society described classification criteria for interstitial pneumonia with autoimmune features (IPAF) to identify patients with lung-predominant CTD who lack sufficient features of a systemic rheumatic disease to meet classification criteria. Although these criteria are imperfect, they are an important attempt to classify the patient with undifferentiated disease for future study. Rheumatologists play a key role in the evaluation of potential IPAF in patients, especially as many patients with a myositis-spectrum disease (e.g., non-Jo-1 antisynthetase syndrome, anti-melanoma differentiation-associated protein 5 antibody inflammatory myositis, or anti-PM/Scl antibody-associated inflammatory myositis) would be classified under IPAF using the currently available criteria for inflammatory myositis, and would therefore benefit from rheumatologic comanagement. The aim of this review was to describe the historical context that led to the development of these criteria and to discuss the limitations of the current criteria, diagnostic challenges, treatment options, and strategies for disease monitoring.
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Affiliation(s)
- Erin M Wilfong
- Vanderbilt University, Nashville, Tennessee, and University of California San Francisco
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27
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Hamaguchi Y, Takehara K. Anti-nuclear autoantibodies in systemic sclerosis : News and perspectives. JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2018; 3:201-213. [PMID: 35382013 PMCID: PMC8922602 DOI: 10.1177/2397198318783930] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 05/20/2018] [Indexed: 02/01/2024]
Abstract
Systemic sclerosis is a connective tissue disorder characterized by microvascular damage and excessive fibrosis of the skin and internal organs. One hallmark of the immunological abnormalities in systemic sclerosis is the presence of anti-nuclear antibodies, which are detected in more than 90% of patients with systemic sclerosis. Anti-centromere antibodies, anti-DNA topoisomerase I antibodies, and anti-RNA polymerase III antibodies are the predominant anti-nuclear antibodies found in systemic sclerosis patients. Other systemic sclerosis-related anti-nuclear antibodies include those targeted against U3 ribonucleoprotein, Th/To, U11/U12 ribonucleoprotein, and eukaryotic initiation factor 2B. Anti-U1 ribonucleoprotein, anti-Ku antibodies, anti-PM-Scl, and anti-RuvBL1/2 antibodies are associated with systemic sclerosis overlap syndrome. Anti-human upstream binding factor, anti-Ro52/TRIM21, anti-B23, and anti-centriole antibodies do not have specificity to systemic sclerosis, but are sometimes detected in sera from patients with systemic sclerosis. Identification of each systemic sclerosis-related antibody is useful to diagnose and predict organ involvement, since the particular type of systemic sclerosis-related antibodies is often predictive of clinical features, severity, and prognosis. The clinical phenotypes are largely influenced by ethnicity. Currently, an immunoprecipitation assay is necessary to detect most systemic sclerosis-related antibodies; therefore, the establishment of an easy, reliable, and simple screening system is warranted.
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Affiliation(s)
- Yasuhito Hamaguchi
- Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan
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28
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Sada PR, García LP, Rodrigo MJE. Clinical heterogeneity of anti-PM/Scl positive conditions. Br J Hosp Med (Lond) 2018; 79:532-533. [DOI: 10.12968/hmed.2018.79.9.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Pablo Ruiz Sada
- Internal Medicine Department. Hospital Reina Sofía, CTRA Tarazona s/n, 31500, Tudela, Navarra, Spain
| | - Lara Palacios García
- Internal Medicine Department. Hospital Universitario de Basurto, Avda. Montevideo, Bilbao, Spain
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29
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Huang CY, Soriano LF, Wakely S, Cavill S, Zrelec S. Hydropneumothorax and intrapulmonary metastases secondary to breast cancer recurrence. Br J Hosp Med (Lond) 2018; 79:533. [PMID: 30188204 DOI: 10.12968/hmed.2018.79.9.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Chieh-Yin Huang
- Foundation Doctor, Department of Acute Medicine, West Middlesex University Hospital, Isleworth TW7 6AF
| | - Livia F Soriano
- Medical Registrar, Department of Acute Medicine, West Middlesex University Hospital, Isleworth
| | - Suzanne Wakely
- Consultant Radiologist, Department of Radiology, West Middlesex University Hospital, Isleworth
| | - Sofia Cavill
- Medical Registrar, Department of Acute Medicine, West Middlesex University Hospital, Isleworth
| | - Sanja Zrelec
- Consultant in Acute Medicine, Department of Acute Medicine, West Middlesex University Hospital, Isleworth
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30
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Palterer B, Vitiello G, Carraresi A, Giudizi MG, Cammelli D, Parronchi P. Bench to bedside review of myositis autoantibodies. Clin Mol Allergy 2018. [PMID: 29540998 PMCID: PMC5840827 DOI: 10.1186/s12948-018-0084-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Idiopathic inflammatory myopathies represent a heterogeneous group of autoimmune diseases with systemic involvement. Even though numerous specific autoantibodies have been recognized, they have not been included, with the only exception of anti-Jo-1, into the 2017 Classification Criteria, thus perpetuating a clinical-serologic gap. The lack of homogeneous grouping based on the antibody profile deeply impacts the diagnostic approach, therapeutic choices and prognostic stratification of these patients. This review is intended to highlight the comprehensive scenario regarding myositis-related autoantibodies, from the molecular characterization and biological significance to target antigens, from the detection tools, with a special focus on immunofluorescence patterns on HEp-2 cells, to their relative prevalence and ethnic diversity, from the clinical presentation to prognosis. If, on the one hand, a notable body of literature is present, on the other data are fragmented, retrospectively based and collected from small case series, so that they do not sufficiently support the decision-making process (i.e. therapeutic approach) into the clinics.
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Affiliation(s)
- Boaz Palterer
- Experimental and Clinical Medicine Department, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Gianfranco Vitiello
- Experimental and Clinical Medicine Department, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Alessia Carraresi
- Experimental and Clinical Medicine Department, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Maria Grazia Giudizi
- Experimental and Clinical Medicine Department, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Daniele Cammelli
- Experimental and Clinical Medicine Department, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Paola Parronchi
- Experimental and Clinical Medicine Department, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
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31
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Castillo R, Albayda J. Dermatomyositis: Autoantibodies and Their Corresponding Phenotypes. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2017. [DOI: 10.1007/s40674-017-0078-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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32
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Prevalence of anti-NT5C1A antibodies in Japanese patients with autoimmune rheumatic diseases in comparison with other patient cohorts. Clin Chim Acta 2017; 472:1-4. [DOI: 10.1016/j.cca.2017.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 06/30/2017] [Accepted: 07/03/2017] [Indexed: 01/05/2023]
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33
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Abe Y, Matsushita M, Tada K, Yamaji K, Takasaki Y, Tamura N. Clinical characteristics and change in the antibody titres of patients with anti-MDA5 antibody–positive inflammatory myositis. Rheumatology (Oxford) 2017; 56:1492-1497. [DOI: 10.1093/rheumatology/kex188] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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34
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Liaskos C, Marou E, Simopoulou T, Barmakoudi M, Efthymiou G, Scheper T, Meyer W, Bogdanos DP, Sakkas LI. Disease-related autoantibody profile in patients with systemic sclerosis. Autoimmunity 2017; 50:414-421. [PMID: 28749191 DOI: 10.1080/08916934.2017.1357699] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Autoantibodies (autoAbs) help in diagnosis and predicting clinical phenotypes in systemic sclerosis (SSc). AIM OF THE STUDY To determine the clinical utility of 13 SSc-related autoAbs in SSc patients. MATERIAL AND METHODS A total of 131 consecutive patients with SSc (111 female, mean age 58.1 ± 14 years; 49 with diffused cutaneous SSc [dcSSc] and 82 with limited cutaneous SSc [lcSSc]) were analysed by a multiplex line immunoassay (Euroimmun) for autoantibodies (autoAbs) against 13 SSc-related antigens. A total of 22 patients with primary Raynaud phenomenon (RP), and 22 healthy controls were also analysed. RESULTS ANA by indirect immunofluorescence was present in 128 (97.7%) patients with SSc. Excluding anti-Ro52, 113 (89.3%) SSc patients were positive for at least one autoAb: anti-Topoisomerase I (anti-Topo) I abs in 54 (41.2%), anti-centromere proteins (anti-CENP) in 37 (28.2%, all reactive with centromere protein-A (CENPA) and centromere protein B (CENPB)), anti-RNA polymerase III(RP11) in 19 (14.5%), anti-RNA polymerase III(RP155) in 13 (9.9%), anti-fibrillarin in 4 (3.1%), anti-Ku in 6 (4.6%), anti-nucleolus-organizing region (anti-NOR90) in 8 (6.1%), anti-PM-Scl100 in 2 (1.5%), and anti-PM-Scl75 in 4 (3.1%). There was no immunoreactivity for Th/To or platelet-derived growth factor receptor (PDGFR). Overall, 102 (77.9%) SSc patients had autoAbs against Topo I, CENPA or CENPB, RP11 or RP155. Anti-Topo I abs were strongly associated with dcSSc, interstitial lung disease (ILD) (p < .001), pulmonary hypertension (PH) (p = .019) and ILD-PH (p = .003). Anti-CENPB abs were associated with lcSSc, and negatively associated with ILD. Anti-RP11 and anti-NOR90 abs were associated with male gender, and anti-NOR90 associated with ILD. CONCLUSIONS Anti-Topo I, anti-CENP, and anti-RNA pol III are the most prevalent autoAbs in SSc. Anti-Topo I and anti-NOR90 abs are associated with ILD and/or PAH.
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Affiliation(s)
- Christos Liaskos
- a Department of Rheumatology and Clinical Immunology , Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece
| | - Emmanouela Marou
- a Department of Rheumatology and Clinical Immunology , Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece.,b Biomedical Section , Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas (CERTH) , Larissa , Greece
| | - Theodora Simopoulou
- a Department of Rheumatology and Clinical Immunology , Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece
| | - Maria Barmakoudi
- a Department of Rheumatology and Clinical Immunology , Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece.,b Biomedical Section , Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas (CERTH) , Larissa , Greece
| | - Georgios Efthymiou
- a Department of Rheumatology and Clinical Immunology , Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece.,b Biomedical Section , Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas (CERTH) , Larissa , Greece
| | - Thomas Scheper
- c Institute of Immunology affiliated to Euroimmun AG , Lübeck , Germany
| | - Wolfgang Meyer
- c Institute of Immunology affiliated to Euroimmun AG , Lübeck , Germany
| | - Dimitrios P Bogdanos
- a Department of Rheumatology and Clinical Immunology , Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece.,b Biomedical Section , Institute of Research and Technology Thessaly, Centre for Research and Technology Hellas (CERTH) , Larissa , Greece.,d Division of Transplantation, Immunology and Mucosal Biology , MRC Centre for Transplantation, King's College London Medical School , London , UK
| | - Lazaros I Sakkas
- a Department of Rheumatology and Clinical Immunology , Faculty of Medicine, School of Health Sciences, University of Thessaly , Larissa , Greece.,e Center for Molecular Medicine , Old Dominion University , Norfolk , VA , USA
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35
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Taki T, Muro Y, Ogawa Y, Akiyama M. Image Gallery: Palmoplantar hyperkeratosis in dermatomyositis with anti-PM/Scl antibodies. Br J Dermatol 2017; 176:e94. [DOI: 10.1111/bjd.15371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- T. Taki
- Department of Dermatology; Nagoya University Graduate School of Medicine; 65 Tsurumai-cho Showa-ku Nagoya 466-8550 Japan
| | - Y. Muro
- Department of Dermatology; Nagoya University Graduate School of Medicine; 65 Tsurumai-cho Showa-ku Nagoya 466-8550 Japan
| | - Y. Ogawa
- Department of Dermatology; Nagoya University Graduate School of Medicine; 65 Tsurumai-cho Showa-ku Nagoya 466-8550 Japan
| | - M. Akiyama
- Department of Dermatology; Nagoya University Graduate School of Medicine; 65 Tsurumai-cho Showa-ku Nagoya 466-8550 Japan
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Bernal-Bello D, de Tena JG, Guillén-Del Castillo A, Selva-O'Callaghan A, Callejas-Moraga EL, Marín-Sánchez AM, Fonollosa-Pla V, Simeón-Aznar CP. Novel risk factors related to cancer in scleroderma. Autoimmun Rev 2017; 16:461-468. [PMID: 28285170 DOI: 10.1016/j.autrev.2017.03.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 02/09/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Emerging data have shown an increased risk of malignancy among patients diagnosed with systemic sclerosis (SSc) so identification of risk factors linking both disorders might have prognostic implications. The aim of this study was to assess the clinical and treatment-related risk factors for cancer in a single-center cohort of patients with SSc. METHODS Demographic, clinical, capillaroscopic, immunological and treatment-related data from 432 consecutive SSc patients were retrospectively analyzed. Variables that reached significant association in the univariate analysis were entered into a logistic regression in order to identify independent risk factors for cancer. RESULTS Malignancy was diagnosed in 53 patients (12.2%). Fifty-eight neoplasms were identified, among which breast (n=15), lung (n=10) and hematologic (n=9) malignancies were the most prevalent. In 19 patients the diagnosis of both scleroderma and tumour was made in <3years apart. Cancer significantly decreased the probability of survival (OR=2.61; 95%CI 1.46-4.69; p=0.001). No association with age, sex, smoking, cutaneous subset or RNA polymerase-III antibodies was found. However, risk of cancer was directly associated with the presence of anti-PM/Scl antibodies (OR=3.90; 95%CI 1.31-11.61; p=0.014), and inversely related to aspirin use (OR=0.33; 95%CI 0.12-0.90; p=0.031), which remained as independent risk factors for cancer on multivariate analysis. CONCLUSIONS PM/Scl antibodies seem to be associated with a higher risk of cancer in scleroderma. In contrast, the use of aspirin is related to a lower risk of cancer in our series. More studies are needed to ascertain the role of anti PM/Scl antibodies and aspirin in the development of malignancy among patients with SSc.
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Affiliation(s)
- David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, C/Camino del Molino, 2, 28942, Fuenlabrada, Madrid, Spain.
| | - Jaime García de Tena
- Department of Internal Medicine, Hospital Universitario de Guadalajara, Universidad de Alcalá, C/Donante de Sangre, s/n, 19002 Guadalajara, Spain.
| | - Alfredo Guillén-Del Castillo
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Albert Selva-O'Callaghan
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Eduardo L Callejas-Moraga
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Ana María Marín-Sánchez
- Department of Immunology, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Vicent Fonollosa-Pla
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
| | - Carmen Pilar Simeón-Aznar
- Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Universidad Autónoma de Barcelona, Spain, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
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Kohara A, Yanaba K, Muro Y, Ito H, Nakagawa H, Noda K, Kurosaka D. Anti-PM/Scl antibody-positive dermatomyositis in a Japanese patient: a case report and review of the literature. Int J Rheum Dis 2017; 20:2186-2189. [DOI: 10.1111/1756-185x.13019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Aki Kohara
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Koichi Yanaba
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Yoshinao Muro
- Department of Dermatology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Hideki Ito
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Hidemi Nakagawa
- Department of Dermatology; The Jikei University School of Medicine; Tokyo Japan
| | - Kentaro Noda
- Department of Rheumatology; The Jikei University School of Medicine; Tokyo Japan
| | - Daitaro Kurosaka
- Department of Rheumatology; The Jikei University School of Medicine; Tokyo Japan
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Muro Y, Sugiura K, Akiyama M. Cutaneous Manifestations in Dermatomyositis: Key Clinical and Serological Features-a Comprehensive Review. Clin Rev Allergy Immunol 2017; 51:293-302. [PMID: 26100618 DOI: 10.1007/s12016-015-8496-5] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Dermatomyositis (DM) is a common idiopathic inflammatory myopathy. The pathogenesis is considered to be microangiopathy affecting skin and muscle. The cutaneous manifestations of DM are the most important aspect of this disease, and their correct evaluation is important for early diagnosis. The skin signs are various: Some are pathognomonic or highly characteristic, and others are compatible with DM. Recently, DM has been categorized into several disease subsets based on the various autoantibodies present in patients. Sometimes, characteristic cutaneous manifestations are strongly associated with the presence of specific autoantibodies. For example, anti-Mi-2 antibody is associated with the classic features of DM, including heliotrope rash, Gottron's papules, the V-neck sign, the shawl sign, cuticular overgrowth, and photosensitivity. Frequent cutaneous features in anti-transcriptional intermediary factor 1 gamma (TIF1γ)-positive patients are diffuse photoerythema, including "dusky red face," while skin ulcerations, palmar papules (inverse Gottron), diffuse hair loss, panniculitis, and oral pain and/or ulcers are sometimes associated with anti-melanoma differentiation-associated gene 5 product (MDA5) antibody. Here, we review important cutaneous manifestations seen in patients with DM, and we examine the relationship between the skin changes and myositis-associated autoantibodies. Correct evaluation of cutaneous manifestations and myositis-associated autoantibodies should help the clinician in the early diagnosis of DM, for a quick recognition of cutaneous signs that may be the symptom of onset before muscle inflammation.
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Affiliation(s)
- Yoshinao Muro
- Division of Connective Tissue Disease and Autoimmunity, Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Kazumitsu Sugiura
- Division of Connective Tissue Disease and Autoimmunity, Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Masashi Akiyama
- Division of Connective Tissue Disease and Autoimmunity, Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
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Pereira A, Borges I, Silva M, Shinjo S. PREVALÊNCIA E REATIVIDADE DOS AUTOANTICORPOS ANTI‐PM/SCL E ANTI‐KU EM PACIENTES COM DERMATOMIOSITE OU POLIMIOSITE. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.07.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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40
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Betteridge Z, McHugh N. Myositis-specific autoantibodies: an important tool to support diagnosis of myositis. J Intern Med 2016; 280:8-23. [PMID: 26602539 DOI: 10.1111/joim.12451] [Citation(s) in RCA: 233] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The idiopathic inflammatory myopathies are characterized by muscle weakness, skin disease and internal organ involvement. Autoimmunity is known to have a role in myositis pathogenesis, and myositis-specific autoantibodies, targeting important intracellular proteins, are regarded as key biomarkers aiding in the diagnosis of patients. In recent years, a number of novel myositis autoantibodies including anti-TIF1, anti-NXP2, anti-MDA5, anti-SAE, anti-HMGCR and anti-cN1A have been identified in both adult and juvenile patients. These autoantibodies correlate with distinct clinical manifestations and importantly are found in inclusion body, statin-induced, clinically amyopathic and juvenile groups of myositis patients, previously believed to be mainly autoantibody negative. In this review, we will describe the main myositis-specific and myositis-associated autoantibodies and their frequencies and clinical associations across different ages and ethnic groups. We will also discuss preliminary studies investigating correlations between specific myositis autoantibody titres and clinical markers of disease course, collectively demonstrating the utility of myositis autoantibodies as both diagnostic and prognostic markers of disease.
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Affiliation(s)
- Z Betteridge
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - N McHugh
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.,Royal National Hospital for Rheumatic Disease, Bath, UK
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41
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Yoshifuji H. Biomarkers and Autoantibodies of Interstitial Lung Disease with Idiopathic Inflammatory Myopathies. CLINICAL MEDICINE INSIGHTS-CIRCULATORY RESPIRATORY AND PULMONARY MEDICINE 2016; 9:141-6. [PMID: 27081322 PMCID: PMC4820065 DOI: 10.4137/ccrpm.s36748] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 02/21/2016] [Accepted: 02/23/2016] [Indexed: 12/29/2022]
Abstract
Various autoantibodies are seen in idiopathic inflammatory myopathies. Among myositis-specific antibodies, anti-aminoacyl-tRNA synthetase and anti-melanoma differentiation-associated protein 5 (MDA5) antibodies are associated with interstitial lung disease (ILD). Anti-MDA5 antibodies are associated with dermatomyositis (DM) or clinically amyopathic DM complicated with rapidly progressive ILD. In anti-MDA5-positive patients, a random ground-glass attenuation pattern is a characteristic finding of ILD in chest high-resolution computed tomography. Conversely, anti-aminoacyl-tRNA synthetase antibodies are not associated with rapidly progressive ILD but with chronic ILD. DM or clinically amyopathic DM patients with anti-MDA5, and characteristic high-resolution computed tomography findings are highly likely to have devastating ILD and need aggressive treatment.
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Affiliation(s)
- Hajime Yoshifuji
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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42
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Wodkowski M, Hudson M, Proudman S, Walker J, Stevens W, Nikpour M, Assassi S, Mayes MD, Tatibouet S, Wang M, Baron M, Fritzler MJ. Clinical correlates of monospecific anti-PM75 and anti-PM100 antibodies in a tri-nation cohort of 1574 systemic sclerosis subjects. Autoimmunity 2015; 48:542-51. [PMID: 26334795 DOI: 10.3109/08916934.2015.1077231] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Autoantibodies directed against the two principal antigens of the human exosome complex, PM75 and PM100, are present in systemic sclerosis (SSc) sera and have been associated with myositis and calcinosis. However, there is a paucity of data on the clinical correlates of these autoantibodies separately and in the absence of other SSc-specific antibodies. The aim of this study was to assess the clinical correlates of monospecific anti-PM75 and anti-PM100 in SSc. METHODS A tri-nation cohort of 1574 SSc subjects was formed, clinical variables were harmonized and sera were tested for anti-PM75 and anti-PM100 antibodies using a line immunoassay. RESULTS Forty-eight (3.0%) subjects had antibodies against PM75 and 18 (1.1%) against PM100. However, only 16 (1%) had monospecific anti-PM75 antibodies and 11 (0.7%) monospecific anti-PM100 antibodies (i.e. in isolation of each other and other SSc-specific antibodies). Monospecific profiles of each autoantibody included more calcinosis. An increased frequency of myositis was only seen in subjects positive for both anti-PM75 and anti-PM100 antibodies. Lung disease was only associated with anti-PM75 and subjects with anti-PM100 antibodies had better survival compared to other antibody subsets. CONCLUSION The prevalence of monospecific anti-PM75 and anti-PM100 antibodies in this large SSc cohort was low. Disease features associated with anti-PM/Scl antibodies may depend on particular and possibly multiple antigen specificities. However, due to the small samples, these results need to be interpreted with caution. International collaborations are key to understanding the clinical correlates of uncommon serological profiles in SSc.
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Affiliation(s)
- Michael Wodkowski
- a Department of Medicine , McGill University , Montréal , Quebec , Canada
| | - Marie Hudson
- a Department of Medicine , McGill University , Montréal , Quebec , Canada .,b Division of Rheumatology , Jewish General Hospital , Montréal , Quebec , Canada .,c Lady Davis Institute, Jewish General Hospital , Montréal , Quebec , Canada
| | - Susanna Proudman
- d Rheumatology Unit, Royal Adelaide Hospital , Adelaide , Australia .,e Discipline of Medicine, University of Adelaide , Bedford Park , Australia
| | - Jennifer Walker
- f Department of Allergy and Immunology , Flinders Medical Centre , Bedford Park , Australia
| | - Wendy Stevens
- g Department of Rheumatology , St. Vincent's Hospital Melbourne , Fitzroy , Victoria , Australia
| | - Mandana Nikpour
- g Department of Rheumatology , St. Vincent's Hospital Melbourne , Fitzroy , Victoria , Australia .,h Department of Medicine , The University of Melbourne at St. Vincent's Hospital , Melbourne , Victoria , Australia
| | - Shervin Assassi
- i Division of Rheumatology and Immunogenetics , University of Texas Health Science Centre at Houston , Houston , TX , USA , and
| | - Maureen D Mayes
- i Division of Rheumatology and Immunogenetics , University of Texas Health Science Centre at Houston , Houston , TX , USA , and
| | - Solène Tatibouet
- c Lady Davis Institute, Jewish General Hospital , Montréal , Quebec , Canada
| | - Mianbo Wang
- c Lady Davis Institute, Jewish General Hospital , Montréal , Quebec , Canada
| | | | | | | | - Murray Baron
- a Department of Medicine , McGill University , Montréal , Quebec , Canada .,b Division of Rheumatology , Jewish General Hospital , Montréal , Quebec , Canada .,c Lady Davis Institute, Jewish General Hospital , Montréal , Quebec , Canada
| | - Marvin J Fritzler
- j Faculty of Medicine, University of Calgary , Calgary , Alberta , Canada
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