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Comprehensive assessment of myositis-specific autoantibodies in polymyositis/dermatomyositis-associated interstitial lung disease.
Respir Med 2016; 121:91-99RM

Abstract

OBJECTIVES

Myositis-specific autoantibodies (MSAs) are associated with clinical phenotypes in polymyositis/dermatomyositis (PM/DM). No study has investigated the clinical features based on comprehensive MSA assessment in PM/DM-associated interstitial lung disease (ILD). We aimed to determine the practical significance of MSAs in PM/DM-ILD.

METHODS

Sixty consecutive PM/DM-ILD patients were retrospectively analysed. Serum MSAs were comprehensively measured using immunoprecipitation assay. Clinical features and prognosis were compared among MSA subgroups.

RESULTS

Twenty-six (43.3%) PM/DM-ILD patients were anti-aminoacyl tRNA-synthetase antibody-positive (anti-ARS-positive), 15 (25.0%) were anti-melanoma differentiation-associated gene 5 antibody-positive (anti-MDA5-positive), 3 (5%) were anti-signal recognition particle antibody-positive, 1 (1.7%) was anti-transcriptional intermediary factor 1-gamma antibody-positive, and 15 (25%) were MSA-negative. There were significant differences in clinical features, including ILD form, serum ferritin and surfactant protein-D levels at ILD diagnosis, and high-resolution CT pattern among the anti-ARS-positive, anti-MDA5-positive and MSA-negative groups. The anti-MDA5-positive group showed the lowest 90-day survival rate (66.7%, anti-MDA5-positive; 100%, anti-ARS-positive; 100%, MSA-negative; P < 0.01). The anti-ARS-positive group had the highest 5-year survival rate (96%, anti-ARS-positive; 66.7%, anti-MDA5-positive; 68.3%, MSA-negative, P = 0.02). Univariate analysis revealed that anti-ARS antibody was associated with better prognosis (HR = 0.45; 95% CI, 0.18-0.89; P = 0.02), whereas anti-MDA5 antibody was associated with poorer prognosis (HR = 1.90; 95% CI, 1.02-3.39; P = 0.04).

CONCLUSIONS

The comprehensive MSA assessment demonstrated that anti-ARS and anti-MDA5 antibodies were two major MSAs, and the clinical features differed depending on MSA status in PM/DM-ILD. Assessment of anti-ARS and anti-MDA5 antibodies is practically useful for predicting clinical course and prognosis in PM/DM-ILD patients.

Authors+Show Affiliations

Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka 431-3192, Japan. Electronic address: jubilooreoresagi@ybb.ne.jp.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka 431-3192, Japan.Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public School Teachers, 3-1 Kurumazuka, Itami, Hyogo 664-8533, Japan.Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1 Chome-3-3 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.Department of IVD Development, Medical & Biological Laboratories Co., Ltd., 1063-103 Terasawaoka, Ina, Nagano 396-0002, Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka 431-3192, Japan.Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka 431-3192, Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka 431-3192, Japan.Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashiku, Hamamatsu, Shizuoka 431-3192, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27888997

Citation

Hozumi, Hironao, et al. "Comprehensive Assessment of Myositis-specific Autoantibodies in Polymyositis/dermatomyositis-associated Interstitial Lung Disease." Respiratory Medicine, vol. 121, 2016, pp. 91-99.
Hozumi H, Fujisawa T, Nakashima R, et al. Comprehensive assessment of myositis-specific autoantibodies in polymyositis/dermatomyositis-associated interstitial lung disease. Respir Med. 2016;121:91-99.
Hozumi, H., Fujisawa, T., Nakashima, R., Johkoh, T., Sumikawa, H., Murakami, A., ... Suda, T. (2016). Comprehensive assessment of myositis-specific autoantibodies in polymyositis/dermatomyositis-associated interstitial lung disease. Respiratory Medicine, 121, pp. 91-99. doi:10.1016/j.rmed.2016.10.019.
Hozumi H, et al. Comprehensive Assessment of Myositis-specific Autoantibodies in Polymyositis/dermatomyositis-associated Interstitial Lung Disease. Respir Med. 2016;121:91-99. PubMed PMID: 27888997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comprehensive assessment of myositis-specific autoantibodies in polymyositis/dermatomyositis-associated interstitial lung disease. AU - Hozumi,Hironao, AU - Fujisawa,Tomoyuki, AU - Nakashima,Ran, AU - Johkoh,Takeshi, AU - Sumikawa,Hiromitsu, AU - Murakami,Akihiro, AU - Enomoto,Noriyuki, AU - Inui,Naoki, AU - Nakamura,Yutaro, AU - Hosono,Yuji, AU - Imura,Yoshitaka, AU - Mimori,Tsuneyo, AU - Suda,Takafumi, Y1 - 2016/11/02/ PY - 2016/06/15/received PY - 2016/10/27/revised PY - 2016/10/31/accepted PY - 2016/11/28/entrez PY - 2016/11/28/pubmed PY - 2018/1/9/medline KW - ARS KW - Dermatomyositis KW - Interstitial pneumonia KW - MDA5 KW - Myositis-specific autoantibody KW - Polymyositis SP - 91 EP - 99 JF - Respiratory medicine JO - Respir Med VL - 121 N2 - OBJECTIVES: Myositis-specific autoantibodies (MSAs) are associated with clinical phenotypes in polymyositis/dermatomyositis (PM/DM). No study has investigated the clinical features based on comprehensive MSA assessment in PM/DM-associated interstitial lung disease (ILD). We aimed to determine the practical significance of MSAs in PM/DM-ILD. METHODS: Sixty consecutive PM/DM-ILD patients were retrospectively analysed. Serum MSAs were comprehensively measured using immunoprecipitation assay. Clinical features and prognosis were compared among MSA subgroups. RESULTS: Twenty-six (43.3%) PM/DM-ILD patients were anti-aminoacyl tRNA-synthetase antibody-positive (anti-ARS-positive), 15 (25.0%) were anti-melanoma differentiation-associated gene 5 antibody-positive (anti-MDA5-positive), 3 (5%) were anti-signal recognition particle antibody-positive, 1 (1.7%) was anti-transcriptional intermediary factor 1-gamma antibody-positive, and 15 (25%) were MSA-negative. There were significant differences in clinical features, including ILD form, serum ferritin and surfactant protein-D levels at ILD diagnosis, and high-resolution CT pattern among the anti-ARS-positive, anti-MDA5-positive and MSA-negative groups. The anti-MDA5-positive group showed the lowest 90-day survival rate (66.7%, anti-MDA5-positive; 100%, anti-ARS-positive; 100%, MSA-negative; P < 0.01). The anti-ARS-positive group had the highest 5-year survival rate (96%, anti-ARS-positive; 66.7%, anti-MDA5-positive; 68.3%, MSA-negative, P = 0.02). Univariate analysis revealed that anti-ARS antibody was associated with better prognosis (HR = 0.45; 95% CI, 0.18-0.89; P = 0.02), whereas anti-MDA5 antibody was associated with poorer prognosis (HR = 1.90; 95% CI, 1.02-3.39; P = 0.04). CONCLUSIONS: The comprehensive MSA assessment demonstrated that anti-ARS and anti-MDA5 antibodies were two major MSAs, and the clinical features differed depending on MSA status in PM/DM-ILD. Assessment of anti-ARS and anti-MDA5 antibodies is practically useful for predicting clinical course and prognosis in PM/DM-ILD patients. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/27888997/Comprehensive_assessment_of_myositis_specific_autoantibodies_in_polymyositis/dermatomyositis_associated_interstitial_lung_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(16)30282-7 DB - PRIME DP - Unbound Medicine ER -