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四种特发性炎性肌病相关的自身抗体-抗 TIF1γ、抗 NXP2、抗 SAE 和抗 MDA5-在匈牙利特发性炎性肌病患者(成人和青少年)队列中。

Four dermatomyositis-specific autoantibodies-anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5-in adult and juvenile patients with idiopathic inflammatory myopathies in a Hungarian cohort.

机构信息

Department of Clinical Immunology, Medical Faculty, University of Debrecen, Móricz Zs. krt. 22. H-4032, Debrecen, Hungary.

Royal National Hospital for Rheumatic Diseases, NHS Foundation Trust, Upper Borough Walls, Bath, Somerset BA1 1RL, UK.

出版信息

Autoimmun Rev. 2014 Dec;13(12):1211-9. doi: 10.1016/j.autrev.2014.08.011. Epub 2014 Aug 23.

Abstract

Idiopathic inflammatory myopathies (IIMs) are chronic systemic autoimmune diseases characterised by symmetrical, proximal muscle weakness. Dermatomyositis represents one subset of IIMs, in which skin rashes are present in addition to muscle weakness. Myositis-specific antibodies can only be detected in myositis, and they are directed against specific proteins found in the cytoplasm or in the nucleus of cells. With this case-based article, we introduce the recently detected anti-TIF1γ, anti-NXP2, anti-SAE and anti-MDA5 antibodies that form various clinical groups. These antibodies could be detected in patients with dermatomyositis. The myositis-specific autoantibodies of three hundred and thirty-seven Hungarian patients with IIM were detected. Retrospective analysis of the clinical findings has also been introduced by revision of the medical history. We had twelve patients with anti-TIF1γ positivity, four patients with anti-NXP2 positivity and four patients with anti-SAE positivity. We did not have any positive anti-MDA5 patients. The most relevant clinical findings were similar to those seen in previously published reports. Eleven of the twelve patients with anti-TIF1γ positivity had classical dermatomyositis. Three of the twelve anti-TIF1γ patients had cancer during the disease progression. This was two out of four for the anti-NXP2 subgroup and one in four for the anti-SAE subgroup. In two juvenile dermatomyositis cases, typical ulceration was seen in patients with anti-TIF1γ positivity. The frequency of pulmonary fibrosis during the disease progression was 2/12, 1/4 and 1/4 in anti-TIF1γ, anti-NXP2 and anti-SAE, respectively. Other extra-muscular manifestations, such as arthralgia, dysphagia, dysphonia and dyspnoea, were also detectable. The myositis subgroups determined by these myositis-specific autoantibodies differ from each other in their symptoms, prognosis and therapy responsiveness. Their detection is helpful for the preparation of an adequate treatment, but in daily diagnostic methods, these antibodies cannot be detected. By presenting our anti-TIF1γ, anti-NXP2 and anti-SAE cases, we would like to highlight the clinical role of these antibodies.

摘要

特发性炎性肌病(IIM)是一种慢性全身性自身免疫性疾病,其特征为对称性、近端肌无力。皮肌炎是 IIM 的一个亚类,除了肌无力外,还存在皮疹。肌炎特异性抗体只能在肌炎中检测到,它们针对细胞浆或细胞核中发现的特定蛋白。通过本文的病例介绍,我们介绍了最近检测到的抗 TIF1γ、抗 NXP2、抗 SAE 和抗 MDA5 抗体,它们形成了各种临床群体。这些抗体可以在皮肌炎患者中检测到。我们检测了 337 名匈牙利特发性肌炎患者的肌炎特异性自身抗体。通过回顾病史,还介绍了对临床发现的回顾性分析。我们有 12 例抗 TIF1γ 阳性,4 例抗 NXP2 阳性,4 例抗 SAE 阳性。我们没有抗 MDA5 阳性患者。最相关的临床发现与以前发表的报告相似。12 例抗 TIF1γ 阳性患者中有 11 例为典型皮肌炎。在疾病进展过程中,12 例抗 TIF1γ 患者中有 3 例患有癌症。这在抗 NXP2 亚组中占 2/4,在抗 SAE 亚组中占 1/4。在 2 例幼年皮肌炎病例中,抗 TIF1γ 阳性患者出现典型溃疡。在疾病进展过程中,抗 TIF1γ、抗 NXP2 和抗 SAE 组的肺纤维化发生率分别为 2/12、1/4 和 1/4。其他肌肉外表现,如关节炎、吞咽困难、声音嘶哑和呼吸困难,也可检测到。这些肌炎特异性自身抗体确定的肌炎亚组在症状、预后和治疗反应性方面存在差异。它们的检测有助于准备适当的治疗,但在日常诊断方法中,这些抗体无法检测到。通过介绍我们的抗 TIF1γ、抗 NXP2 和抗 SAE 病例,我们想强调这些抗体的临床作用。

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