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Diederichsen LP, Iversen LV, Nielsen CT, Jacobsen S, Hermansen ML, Witting N, Cortes R, Korsholm SS, Krogager ME, Friis T. Myositis-related autoantibody profile and clinical characteristics stratified by anti-cytosolic 5'-nucleotidase 1A status in connective tissue diseases. Muscle Nerve 2023. [PMID: 37177880 DOI: 10.1002/mus.27841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
INTRODUCTION/AIMS Cytosolic 5'-nucleotidase 1A (cN-1A) autoantibodies have been recognized as myositis-related autoantibodies. However, their correlations with clinical characteristics and other myositis-specific and myositis-associated autoantibodies (MSAs/MAAs) are still unclear. We aimed to establish the prevalence and clinical and laboratory associations of cN-1A autoantibodies in a cohort of patients with connective tissue diseases. METHODS A total of 567 participants (182 idiopathic inflammatory myopathies [IIM], 164 systemic lupus erythematosus [SLE], 121 systemic sclerosis [SSc], and 100 blood donors [BD]) were tested for the presence of cN-1A autoantibodies and other myositis-specific and myositis-associated autoantibodies (MSAs/MAAs). Clinical and laboratory characteristics were compared between anti-cN-1A positive and negative patients with sporadic inclusion body myositis (sIBM) and between anti-cN-1A positive and negative patients with non-IBM IIM. RESULTS In the sIBM cohort, 30 patients (46.9%) were anti-cN-1A positive vs. 18 (15.2%) in the non-IBM IIM cohort, 17 (10%) were anti-cN-1A positive in the SLE cohort and none in the SSc or the BD cohorts. Anti-cN-1A positivity had an overall sensitivity of 46.9% and a specificity of 93.2% for sIBM. Dysphagia was more frequent in the anti-cN-1A positive vs. negative sIBM patients (p = .04). In the non-IBM IIM group, being anti-cN-1A antibody positive was associated with the diagnosis polymyositis (p = .04) and overlap-myositis (p = .04) and less disease damage evaluated by physician global damage score (p < .001). DISCUSSION cN-1A autoantibodies were predominantly found in IIM patients and was associated with dysphagia in sIBM patients. Notably, anti-cN-1A appears to identify a distinct phenotype of anti-cN-1A positive non-IBM IIM patients with a milder disease course.
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Affiliation(s)
- Louise Pyndt Diederichsen
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | - Line Vinderslev Iversen
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Dermatology, Odense University Hospital, Odense, Denmark
| | - Christoffer Tandrup Nielsen
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Søren Jacobsen
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Marie-Louise Hermansen
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Nanna Witting
- Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Rikke Cortes
- Department of Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Sine Søndergaard Korsholm
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | | | - Tina Friis
- Department of Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
- Department of Autoimmunology and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
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Korsholm SS, Andersson DC, Knudsen JB, Dastmalchi M, Diederichsen ACP, Gerke O, Witting N, Jacobsen S, Pecini R, Friis T, Krogager ME, Lundberg IE, Diederichsen O. Myositis-Specific Autoantibodies and QTc Changes by ECG in Idiopathic Inflammatory Myopathies. Rheumatology (Oxford) 2022; 61:4076-4086. [PMID: 35048961 DOI: 10.1093/rheumatology/keac013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/27/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate cardiac involvement detected by electrocardiography (ECG) in patients with idiopathic inflammatory myopathies (IIM) and to evaluate possible associations between autoantibody profile and ECG changes in these patients. METHODS In a Scandinavian cross-sectional study, patients were included from two Danish centres and one Swedish centre. Resting 12-lead ECG was investigated in 261 patients with IIM compared with 102 patients with systemic sclerosis (SSc) and 48 healthy controls (HCs). ECG changes were correlated to clinical manifestations and myositis-specific (MSAs) and myositis-associated (MAAs) autoantibodies. RESULTS Patients with IIM had longer mean QTc duration and more frequently presented with prolonged QTc (≥ 450 ms; p= 0.038) compared with HCs. Longer QTc duration was recorded in SSc compared with IIM (433 ± 23 ms vs 426 ± 24 ms, p= 0.011), yet, no significant difference in the fraction with prolonged QTc (SSc: 22%, IIM: 16%; p= 0.19). In multivariable regression analyses, anti-Mi2 (p= 0.01, p= 0.035) and anti-Pl-7 (p= 0.045, p= 0.014) were associated with QTc duration and prolonged QTc in IIM. Elevated CRP was associated with prolonged QTc (p= 0.041). CONCLUSION Presence of QTc abnormalities was as common in patients with IIM as in patients with SSc, including prolonged QTc seen in almost one fifth of the patients. Anti-Mi2, anti-Pl-7, and elevated CRP may serve as biomarkers for cardiac disease in IIM, but needs to be confirmed in a larger prospective study.
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Affiliation(s)
- Sine Søndergaard Korsholm
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital (CUH), Rigshospitalet, Denmark, Copenhagen.,Dept of Rheumatology, Odense University Hospital (OUH), Odense, Denmark
| | - Daniel C Andersson
- Dept of Physiology and Pharmacology, Karolinska Institute, Solna, Stockholm, Sweden.,Heart, Vascular and Neurology Theme, Cardiology Unit, Karolinska University Hospital, Stockholm, Sweden
| | | | - Maryam Dastmalchi
- Division of Rheumatology, Dept of medicine, Solna, Stockholm, Karolinska Institutet and Rheumatology, Karolinska University Hospital, Solna, Stockholm, Sweden
| | | | - Oke Gerke
- Dept of Nuclear Medicine, OUH, Odense, Denmark
| | | | - Søren Jacobsen
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital (CUH), Rigshospitalet, Denmark, Copenhagen
| | - Redi Pecini
- Dept of Cardiology, CUH, Copenhagen, Denmark
| | - Tina Friis
- Dept of Autoimmunology and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | | | - Ingrid E Lundberg
- Division of Rheumatology, Dept of medicine, Solna, Stockholm, Karolinska Institutet and Rheumatology, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Ouise Diederichsen
- Center for Rheumatology and Spine Diseases, Copenhagen University Hospital (CUH), Rigshospitalet, Denmark, Copenhagen.,Dept of Rheumatology, Odense University Hospital (OUH), Odense, Denmark
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