Dataset Information

Narrative review of autoantibodies in idiopathic inflammatory myopathies.

ABSTRACT:

Objective

To discuss the characteristics of autoantigens, detection methods and roles of myositis associated autoantibodies (MAAs) and myositis specific autoantibodies (MSAs), as well as the clinical features of disease subgroups defined by MAAs/MSAs.

Background

Autoantibodies in patients with idiopathic inflammatory myopathies (IIMs) are conventionally divided into MAAs and MSAs. MAAs usually refer to autoantibodies which are also available in systematic autoimmune diseases (anti-PM/SCL, anti-Ku, anti-Ro52 and anti-U1RNP antibodies). MSAs refer to autoantibodies which were distinctive for IIM (anti-Mi-2, anti-MDA5, anti-TIF1gammma, anti-NXP2, anti-SAE, anti-synthetase, anti-SRP, anti-HMGCR and anti-cN1A antibodies). The discovery and identification of novel autoantigens is a long and complicated process, which brought light in immunopathogenesis of IIMs. Detection methods of MAAs/MSAs mainly consist of monospecific methods [immunoprecipitation, enzyme-linked immune sorbent assay (ELISA) and indirect immunofluorescence] and multispecific methods [line immunoassay (LIA), dot immunoassay (DIA) and addressable laser bead assay (ALBIA)]. Patients with different MAAs/MSAs have different clinical features and require different clinical management.

Methods

The search engine PubMed (https://www.ncbi.nlm.nih.gov/pmc/) was used to research the keywords "autoantibodies", "idiopathic inflammatory myopathies", "detection methods" and "clinical features". A narrative review was conducted to literature findings from 1975 to 2020.

Conclusions

Development and validation of efficient detection methods of MAAs and MSAs help clinicians for diagnosis, classification and management of IIMs. The exploration of clinical features associated with different autoantibodies that facilitate the creation of diagnostic and classification guidelines and further clinical decision-making is of high value.

SUBMITTER: Liu Y

PROVIDER: S-EPMC10116429 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Publications

Narrative review of autoantibodies in idiopathic inflammatory myopathies.

Liu Yilin Y Zheng Yiming Y Hao Hongjun H Yuan Yun Y

Annals of translational medicine 20211210 7

<h4>Objective</h4>To discuss the characteristics of autoantigens, detection methods and roles of myositis associated autoantibodies (MAAs) and myositis specific autoantibodies (MSAs), as well as the clinical features of disease subgroups defined by MAAs/MSAs.<h4>Background</h4>Autoantibodies in patients with idiopathic inflammatory myopathies (IIMs) are conventionally divided into MAAs and MSAs. MAAs usually refer to autoantibodies which are also available in systematic autoimmune diseases (anti ...[more]

PMID: 37090051

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Project description:ImportanceIdiopathic inflammatory myopathies are heterogeneous in their pathophysiologic features and prognosis. The emergence of myositis-specific autoantibodies suggests that subgroups of patients exist.ObjectiveTo develop a new classification scheme for idiopathic inflammatory myopathies based on phenotypic, biological, and immunologic criteria.Design, setting, and participantsAn observational, retrospective cohort study was performed using a database of the French myositis network. Patients identified from referral centers for neuromuscular diseases were included from January 1, 2003, to February 1, 2016. Of 445 initial patients, 185 patients were excluded and 260 adult patients with myositis who had complete data and defined historical classifications for polymyositis, dermatomyositis, and inclusion body myositis were enrolled. All patients were tested for anti-histidyl-ARN-t- synthetase (Jo1), anti-threonine-ARN-t-synthetase (PL7), anti-alanine-ARN-t-synthetase (PL12), anti-complex nucleosome remodeling histone deacetylase (Mi2), anti-Ku, anti-polymyositis/systemic scleroderma (PMScl), anti-topoisomerase 1 (Scl70), and anti-signal recognition particle (SRP) antibodies. A total of 708 variables were collected per patient (eg, cancer, lung involvement, and myositis-specific antibodies).Main outcomes and measuresUnsupervised multiple correspondence analysis and hierarchical clustering analysis to aggregate patients in subgroups.ResultsAmong 260 participants (163 [62.7%] women; mean age, 59.7 years; median age [range], 61.5 years [48-71 years]), 4 clusters of patients emerged. Cluster 1 (n = 77) included patients who were male, white, and older than 60 years and had finger flexor and quadriceps weakness and findings of vacuolated fibers and mitochondrial abnormalities. Cluster 1 regrouped patients who had inclusion body myositis (72 of 77 patients [93.5%]; 95% CI, 85.5%-97.8%; P < .001). Cluster 2 (n = 91) regrouped patients who were women and had high creatine phosphokinase levels, necrosis without inflammation, and anti-SRP or anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibodies corresponding to immune-mediated necrotizing myopathy (53 of 91 [58.2%]; 95% CI, 47.4%-68.5%; P < .001). Cluster 3 (n = 52) regrouped patients who had dermatomyositis rash and anti-Mi2, anti-melanoma differentiation-associated protein 5 (MDA5), or anti-transcription intermediary factor-1γ (TIF1γ) antibodies, mainly corresponding with patients who had dermatomyositis (43 of 52 [82.7%]; 95% CI, 69.7%-91.8%; P < .001). Cluster 4 (n = 40) was defined by the presence of anti-Jo1 or anti-PL7 antibodies corresponding to antisynthetase syndrome (36 of 40 [90.0%]; 95% CI, 76.3%-97.2%; P < .001). The classification of an independent cohort (n = 50) confirmed the 4 clusters (Cohen κ light, 0.8; 95% CI, 0.6-0.9).Conclusions and relevanceThese findings suggest a classification of idiopathic inflammatory myopathies with 4 subgroups: dermatomyositis, inclusion body myositis, immune-mediated necrotizing myopathy, and antisynthetase syndrome. This classification system suggests that a targeted clinical-serologic approach for identifying idiopathic inflammatory myopathies may be warranted.

Dataset Information

Narrative review of autoantibodies in idiopathic inflammatory myopathies.

Objective

Background

Methods

Conclusions

Publications

Narrative review of autoantibodies in idiopathic inflammatory myopathies.

Similar Datasets

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