Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
Curr Opin Rheumatol. 2019 Nov;31(6):643-649. doi: 10.1097/BOR.0000000000000641.
The aim of this study is to provide a comprehensive overview of the current insight about the clinical utility of cancer-associated autoantibodies (CAAs) as biomarkers in paraneoplastic myositis syndrome (PMS). In addition, the possible mechanisms of the relationship between malignancy and myositis onset are discussed.
It has become increasingly clear that a subgroup of the myositis-specific autoantibodies could be considered as CAAs because they are closely related to the PMS. Increased risk of cancer was found in patients with antitranscriptional intermediary factor 1-γ (TIF1-γ), antinuclear matrix protein-2 (NXP-2), anti3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) or antismall ubiquitin-like modifier 1-activating enzyme (SAE) antibodies. However, the diagnosing sensitivity and specificity of these CAAs for PMS are different among different cohort studies. Abnormally expressed or mutated autoantigen genes in tumor could possibly induce cross immunity against self-proteins and subsequently lead to the development of PMS.
Anti-TIF1-γ, anti-NXP-2, anti-HMGCR and anti-SAE antibodies may act as CAAs in PMS. It is necessary to closely screen and monitor for cancer in patients with CAAs. The recent studies of the relationship between CAAs and PMS provided important new insights into the disease mechanisms.
本研究旨在全面概述癌相关自身抗体(CAAs)作为副肿瘤性肌炎综合征(PMS)生物标志物的临床应用价值。此外,还讨论了恶性肿瘤与肌炎发病之间关系的可能机制。
越来越明显的是,一组肌炎特异性自身抗体可以被认为是 CAAs,因为它们与 PMS 密切相关。抗转录中介因子 1-γ(TIF1-γ)、核基质蛋白-2(NXP-2)、抗 3-羟-3-甲基戊二酰辅酶 A 还原酶(HMGCR)或抗小分子泛素样修饰酶 1 激活酶(SAE)抗体的患者癌症风险增加。然而,这些 CAAs 对 PMS 的诊断敏感性和特异性在不同的队列研究中有所不同。肿瘤中异常表达或突变的自身抗原基因可能诱导针对自身蛋白的交叉免疫,从而导致 PMS 的发生。
抗 TIF1-γ、抗 NXP-2、抗 HMGCR 和抗 SAE 抗体可能作为 PMS 中的 CAAs 发挥作用。有必要对 CAAs 患者进行密切筛查和监测癌症。最近关于 CAAs 与 PMS 关系的研究为该疾病的发病机制提供了重要的新见解。