Institute of Internal Medicine, Department of Rheumatology, Division of Clinical Immunology, University of Debrecen Medical and Health Science Center, Debrecen, Hungary.
Joint Bone Spine. 2010 Mar;77(2):125-30. doi: 10.1016/j.jbspin.2009.08.008. Epub 2010 Feb 25.
The current study was performed in order to determine the prevalence of different myositis-specific and myositis-associated antibodies, as well as their association with clinical characteristics, disease course and response to therapy in 169 Hungarian patients with idiopathic inflammatory myopathy.
Sera of 130 primary and 39 overlap myositis including systemic sclerosis (13), rheumatoid arthritis (12), systemic lupus erythematosus (5) and Sjögren's syndrome (9) cases were analyzed. Antinuclear antibody, scleroderma-associated antibodies (anti-centromere, anti-topoisomerase I), anti-Jo-1, anti-PL-7, anti-PL-12, anti-Mi-2, anti-SRP and anti-PM-Scl, anti-Ku, anti-SS-A, anti-SS-B, anti-U1snRNP were tested. Autoantibody results were compared with clinical characteristics, disease course of overlap versus primary myositis patients, as well as with response to therapy.
Associated connective tissue disease occurred in 23.1% of the patients. Myositis-associated antibodies were found in 8.5% of primary myositis patients, indicating that 11 additional primary myositis patients (23% vs. 29.6%) can be classified as overlap in all cohort according to the newly proposed diagnostic criteria. Polymyositis was found to be the most common myositis form in overlap myositis (87.2%), while scleroderma was the most common disease associated (33.3%). ANA was positive in 25.4% of primary and in 61.5% of overlap myositis cases. Altogether 39.6% of myositis patients (n=67) had autoantibodies, most commonly anti Jo-1 (18.3%) correlating with a polycyclic disease course.
Inclusion of myositis-specific and associated antibodies into the newly proposed diagnostic criteria for inflammatory myopathies is of great importance in order to determine subclasses and to introduce adequate therapy in time.
本研究旨在确定 169 例匈牙利特发性炎性肌病患者不同肌炎特异性和肌炎相关抗体的流行情况，以及它们与临床特征、疾病过程和治疗反应的关系。
分析了 130 例原发性和 39 例重叠性肌炎（包括系统性硬化症 13 例、类风湿关节炎 12 例、系统性红斑狼疮 5 例和干燥综合征 9 例）患者的血清。检测了抗核抗体、硬皮病相关抗体（抗着丝点、抗拓扑异构酶 I）、抗 Jo-1、抗 PL-7、抗 PL-12、抗 Mi-2、抗 SRP 和抗 PM-Scl、抗 Ku、抗 SS-A、抗 SS-B、抗 U1snRNP。比较了自身抗体结果与临床特征、重叠与原发性肌炎患者的疾病过程以及与治疗反应的关系。
23.1%的患者合并结缔组织病。原发性肌炎患者中发现肌炎相关抗体 8.5%，提示根据新提出的诊断标准，所有患者中 11 例原发性肌炎患者（23%比 29.6%）可归类为重叠。重叠性肌炎中最常见的肌炎形式是多发性肌炎（87.2%），最常见的相关疾病是硬皮病（33.3%）。原发性和重叠性肌炎病例中 ANA 阳性率分别为 25.4%和 61.5%。共有 39.6%的肌炎患者（n=67）存在自身抗体，最常见的是抗 Jo-1（18.3%），与多环疾病过程相关。
将肌炎特异性和相关抗体纳入新提出的炎性肌病诊断标准对于确定亚类和及时引入适当的治疗非常重要。
