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皮肌炎/多发性肌炎伴间质性肺病中的肌炎特异性自身抗体。

Myositis-specific autoantibodies in dermatomyositis/polymyositis with interstitial lung disease.

机构信息

Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, PR China.

Clinical Diagnostic Center, 302 Military Hospital of China, Beijing 100039, PR China.

出版信息

J Neurol Sci. 2019 Feb 15;397:123-128. doi: 10.1016/j.jns.2018.12.040. Epub 2018 Dec 31.

DOI:10.1016/j.jns.2018.12.040
PMID:30616054
Abstract

AIM

The prevalence and diagnostic values of myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs) in dermatomyositis/polymyositis (DM/PM) were studied.

METHOD

A commercial immunoblot assay with 16 autoantigens was used to detect MSAs and MAAs in serum samples from 130 DM/PM patients, 100 disease controls, and 50 healthy subjects.

RESULTS

The prevalence of anti-Jo-1, anti-MDA5, anti-TIF1γ, anti-Mi-2α, and anti-Mi-2β was significantly higher in DM/PM than in other connective-tissue diseases (CTDs). Moreover, anti-MDA5 and anti-Ro-52 were significantly higher in DM/PM with interstitial lung disease (ILD) than in DM/PM without ILD, while that of anti-TIF1γ and anti-NXP2 were significantly lower in DM/PM with ILD than in DM/PM without ILD. For distinguishing DM/PM from other CTDs, the sensitivity, specificity, and positive predictive value (PPV) for anti-MDA5 were 28.46, 99.00, and 97.37%, respectively, with a positive likelihood ratio (LR+) of 28.46; they were 46.15, 58.00, and 58.82%, respectively, for anti-Ro-52 with an LR+ of 1.10. For distinguishing DM/PM with ILD from DM/PM without ILD, the sensitivity, specificity, and PPV for anti-MDA5 were 45.57, 100.00, and 100.00%, respectively, and for anti-Ro-52 were 60.76, 73.91, and 80.00%, respectively.

CONCLUSION

MSAs and MAAs serve as biomarkers for differentiating DM/PM from other CTDs as well as distinguishing DM/PM with ILD from DM/PM without ILD.

摘要

目的

研究皮肌炎/多发性肌炎(DM/PM)患者肌炎特异性自身抗体(MSAs)和肌炎相关自身抗体(MAAs)的流行率及其诊断价值。

方法

采用包含 16 种自身抗原的商业免疫印迹法检测 130 例 DM/PM 患者、100 例疾病对照者和 50 例健康对照者血清中的 MSAs 和 MAAs。

结果

与其他结缔组织疾病(CTD)相比,抗-Jo-1、抗-MDA5、抗-TIF1γ、抗-Mi-2α 和抗-Mi-2β在 DM/PM 中的阳性率显著更高。此外,在有间质性肺病(ILD)的 DM/PM 中,抗-MDA5 和抗-Ro-52 的阳性率显著高于无 ILD 的 DM/PM,而在有 ILD 的 DM/PM 中,抗-TIF1γ 和抗-NXP2 的阳性率显著低于无 ILD 的 DM/PM。在区分 DM/PM 与其他 CTD 方面,抗-MDA5 的敏感性、特异性和阳性预测值(PPV)分别为 28.46%、99.00%和 97.37%,阳性似然比(LR+)为 28.46;抗-Ro-52 的敏感性、特异性和 PPV 分别为 46.15%、58.00%和 58.82%,LR+为 1.10。在区分有 ILD 的 DM/PM 与无 ILD 的 DM/PM 方面,抗-MDA5 的敏感性、特异性和 PPV 分别为 45.57%、100.00%和 100.00%,抗-Ro-52 的敏感性、特异性和 PPV 分别为 60.76%、73.91%和 80.00%。

结论

MSAs 和 MAAs 可作为区分 DM/PM 与其他 CTD 以及有 ILD 的 DM/PM 与无 ILD 的 DM/PM 的生物标志物。

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