Prevalence of Myositis-Specific Antibodies in Idiopathic Interstitial Pneumonias

Sadeleer, Laurens J. De; Langhe, Ellen De; Bodart, Nicolas; Vigneron, Alain; Bossuyt, Xavier; Wuyts, Wim

doi:10.1007/s00408-018-0108-8

Cited by 17 publications

(19 citation statements)

References 16 publications

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“…Interestingly, 70% had an IP without underlying CTD [33,34,41], which is agreement with 80% of anti-Ks positivity found our non-CTD-ILDs. Radiological and/or histological patterns of NSIP and OP (range 6-85.7%) have been described in ILD with anti-Ks [32,[41][42][43] and other anti-t-RNA synthetases [11,16,23,25]. These results are in congruence with the presence of non-UIP patterns in our study.…”

Section: Discussionsupporting

confidence: 91%

“…The findings of this study raise the question why antibodies are present in idiopathic IP, including IPF. An IP can occur two years before an associated CTD [3,6], but antibodies are present in true idiopathic IP as well [11,16,[23][24][25]. In several studies, autoantibody producing plasma cells were identified in fibrotic lung tissue [47].…”

Section: Discussionmentioning

confidence: 99%

“…Serologic testing for autoantibodies by a myositis blot is recommended in pulmonary fibrosis suspected for an underlying CTD, which includes myositis specific antibodies (MSA) and myositis associated antibodies (MAA) [ 1 , 3 , 4 , 6 , 11 , 12 , 13 , 14 , 15 , 16 ]. MSA and MAA are found in patients with idiopathic interstitial myopathies but also occur in patients with rheumatic diseases including CTD-ILDs [ 3 , 4 , 5 , 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Moreover, myositis antibody positivity has been described in other ILDs, including hypersensitivity pneumonitis (HP) and idiopathic IPs [ 11 , 16 , 23 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

“…MSA and MAA are found in patients with idiopathic interstitial myopathies but also occur in patients with rheumatic diseases including CTD-ILDs [ 3 , 4 , 5 , 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. Moreover, myositis antibody positivity has been described in other ILDs, including hypersensitivity pneumonitis (HP) and idiopathic IPs [ 11 , 16 , 23 , 24 , 25 ]. However, many suspected patients are negative for the standard set of autoantibodies.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Novel Myositis Autoantibodies in a Large Cohort of Patients with Interstitial Lung Disease

Moll

Platenburg

Platteel

et al. 2020

JCM

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Connective tissue diseases (CTDs) are an important secondary cause of interstitial lung disease (ILD). If a CTD is suspected, clinicians are recommended to perform autoantibody testing, including for myositis autoantibodies. In this study, the prevalence and clinical associations of novel myositis autoantibodies in ILD are presented. A total of 1194 patients with ILD and 116 healthy subjects were tested for antibodies specific for Ks, Ha, Zoα, and cN1A with a line-blot assay on serum available at the time of diagnosis. Autoantibodies were demonstrated in 63 (5.3%) patients and one (0.9%) healthy control (p = 0.035). Autoantibodies were found more frequently in females (p = 0.042) and patients without a histological and/or radiological usual interstitial pneumonia (UIP; p = 0.010) and a trend towards CTD-ILDs (8.4%) was seen compared with other ILDs (4.9%; p = 0.090). The prevalence of antibodies specific for Ks, Ha, Zoα, and cN1A was, respectively, 1.3%, 2.0%, 1.4%, and 0.9% in ILD. Anti-Ha and Anti-Ks were observed in males with unclassifiable idiopathic interstitial pneumonia (unclassifiable IIP), hypersensitivity pneumonitis (HP), and various CTD-ILDs, whereas anti-cN1A was seen in females with antisynthetase syndrome (ASS), HP, and idiopathic pulmonary fibrosis (IPF). Anti-Zoα was associated with CTD-ILD (OR 2.5; 95%CI 1.11–5.61; p = 0.027). In conclusion, a relatively high prevalence of previously unknown myositis autoantibodies was found in a large cohort of various ILDs. Our results contribute to the awareness that circulating autoantibodies can be found in ILDs with or without established CTD. Whether these antibodies have to be added to the standard set of autoantibodies analysed in conventional myositis blot assays for diagnostic purposes in clinical ILD care requires further study.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of Novel Myositis Autoantibodies in a Large Cohort of Patients with Interstitial Lung Disease

Moll

Platenburg

Platteel

et al. 2020

JCM

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“…Anti-SAE1 is frequently reported in dermatomyositis as shown in various assays such as line-blot of Euroimmun [ 13 ] or Alphadia dot immunoassay [ 22 ], but this association was not significant in our study population. Other known associations were confirmed, such as anti-MDA-5 and anti-TIF1-γ with skin involvement [ [24] , [25] , [26] ] and anti-Jo-1 with lung involvement [ 22 , 27 ].…”

Section: Discussionmentioning

confidence: 96%

Frequencies and clinical associations of myositis-related antibodies in The Netherlands: A one-year survey of all Dutch patients

Platteel

Wevers

Lim

et al. 2019

Journal of Translational Autoimmunity

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Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of connective tissue diseases, collectively known as myositis. Diagnosis of IIM is challenging while timely recognition of an IIM is of utter importance considering treatment options and otherwise irreversible (severe) long-term clinical complications. With the EULAR/ACR classification criteria (2017) considerable advancement has been made in the diagnostic workup of IIM. While these criteria take into account clinical parameters as well as presence of one autoantibody, anti-Jo-1, several autoantibodies are associated with IIM and are currently evaluated to be incorporated into classification criteria. As individual antibodies occur at low frequency, the development of line blots allowing multiplex antibody analysis has improved laboratory diagnostics for IIM. The Euroline myositis line-blot assay (Euroimmun) allows screening and semi-quantitative measurement for 15 autoantibodies, i.e . myositis specific antibodies (MSA) to SRP, EJ, OJ, Mi-2α, Mi-2β, TIF1-γ, MDA5, NXP2, SAE1, PL-12, PL-7, Jo-1 and myositis associated antibodies (MAA) to Ku, PM/Scl-75 and PM/Scl-100. To evaluate the clinical significance of detection and levels of these autoantibodies in the Netherlands, a retrospective analysis of all Dutch requests for extended myositis screening within a 1 year period was performed. A total of 187 IIM patients and 632 non-IIM patients were included. We conclude that frequencies of MSA and MAA observed in IIM patients in a routine diagnostic setting are comparable to cohort-based studies. Weak positive antibody levels show less diagnostic accuracy compared to positive antibody levels, except for anti-NXP2. Known associations between antibodies and skin involvement (anti-MDA5, anti-TIF1-γ), lung involvement (anti-Jo-1), and malignancy (anti-TIF1-γ) were confirmed in our IIM study population. The availability of multiplex antibody analyses will facilitate inclusion of additional autoantibodies in clinical myositis guidelines and help to accelerate diagnosing IMM with rare but specific antibodies.

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Association of extended myositis panel results, clinical features, and diagnoses: a single-center retrospective observational study

et al. 2021

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Myositis-specific antibodies (MSA) and myositis-associated antibodies (MAA) are a feature of the idiopathic inflammatory myopathies (IIM), but are also seen in other rheumatic diseases, and in individuals with no clinical symptoms. The aim of this study was to assess the clinical utility of MSA and MAA and in particular the clinical relevance of weakly positive results. We included all patients at our institution who had at least one positive result on the Immunoblot EUROLINE myositis panel over a 6-year period (2015–2020). Associations with clinical features and final diagnosis were evaluated. Eighty-seven of 225 (39%) myositis panel tests met the inclusion criteria. There were 52 strong positives and 35 weak positives for one or more MSA/MAAs. Among the strong positive group, 15% (8/52) were diagnosed with IIM, 34.6% (18/52) with interstitial lung disease, 7.7% (4/52) with anti-synthetase syndrome, 25% (13/52) with connective tissue disease, and others accounted for 25% (13/52). In weak-positive cases, only 14% (5/35) had connective tissue disease and none had IIM. 60% (21/35) of weak-positive cases were not associated with a specific rheumatic disease. A significant number of positive myositis panel results, particularly weak positives, are not associated with IIM or CTD.

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Prevalence of Myositis-Specific Antibodies in Idiopathic Interstitial Pneumonias

Cited by 17 publications

References 16 publications

Prevalence of Novel Myositis Autoantibodies in a Large Cohort of Patients with Interstitial Lung Disease

Prevalence of Novel Myositis Autoantibodies in a Large Cohort of Patients with Interstitial Lung Disease

Frequencies and clinical associations of myositis-related antibodies in The Netherlands: A one-year survey of all Dutch patients

Association of extended myositis panel results, clinical features, and diagnoses: a single-center retrospective observational study

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