Zhao Ling, Su Kaisheng, Liu Tao, Sun Dejun, Jiang Zhenyu
Department of Rheumatology, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, 130021, Jilin, China.
Laboratory of Biomedicine, Jilin University of Pharmaceutical Sciences, Changchun, 130021, Jilin, China.
Clin Rheumatol. 2021 Mar;40(3):1009-1016. doi: 10.1007/s10067-020-05273-3. Epub 2020 Jul 16.
To determine the relationship of myositis autoantibodies with the diagnosis and severity of idiopathic inflammatory myopathy (IIM) using the 2017 EULAR/ACR idiopathic inflammatory myopathy classification criteria and the myositis disease activity assessment tool (MDAAT).
Patients who met the new diagnostic criteria were tested for serum myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs), and then classified into different subgroups based on autoantibody positivity. Patients were also diagnosed with possible IIM, probable IIM, and definite IIM. The MDAAT was used to evaluate muscular and extramuscular disease activity. The relationships of diagnostic classification with positivity for different myositis autoantibodies were determined.
There were 118 patients, and 81% of them had one or more myositis autoantibody. Anti-Jo-1 was the most common MSA, and anti-Ro-52 was the most common MAA. Sixteen patients (14%) had possible IIM, 36 (31%) had probable IIM, and 66 (56%) had definite IIM. MSA-positive patients were significantly more common in the definite IIM group, but MAA positivity was unrelated to diagnostic classification. Positivity for MSAs or MAAs had no correlations with muscle disease activity. Extramuscular disease activity was greater in MSA-positive than MSA-negative patients, but MAA positivity had no significant association with extramuscular disease activity.
MSA positivity aids in the diagnosis of IIM. MSA positivity was associated with greater extramuscular disease activity. Improving the clinical application of MSAs may enhance the individualized treatment of patients with IMM. Key Points • In this paper, we explore the relationships between the myositis autoantibodies and the diagnosis and the disease activity of inflammatory myopathy. • Positive myositis-specific autoantibodies is associated with the establishment of diagnosis and higher extramuscular disease activity. • Thus, more extensive application of myositis autoantibodies maybe the key for further disease assessment and research.
采用2017年欧洲抗风湿病联盟/美国风湿病学会（EULAR/ACR）特发性炎性肌病分类标准和肌炎疾病活动评估工具（MDAAT），确定肌炎自身抗体与特发性炎性肌病（IIM）诊断及严重程度之间的关系。
对符合新诊断标准的患者检测血清肌炎特异性自身抗体（MSA）和肌炎相关性自身抗体（MAA），然后根据自身抗体阳性情况分为不同亚组。患者还被诊断为可能的IIM、很可能的IIM和确诊的IIM。使用MDAAT评估肌肉和肌肉外疾病活动。确定不同肌炎自身抗体阳性与诊断分类之间的关系。
共118例患者，其中81%有1种或更多种肌炎自身抗体。抗Jo-1是最常见的MSA，抗Ro-52是最常见的MAA。16例患者（14%）为可能的IIM，36例（31%）为很可能的IIM，66例（56%）为确诊的IIM。MSA阳性患者在确诊的IIM组中明显更常见，但MAA阳性与诊断分类无关。MSA或MAA阳性与肌肉疾病活动无相关性。MSA阳性患者的肌肉外疾病活动高于MSA阴性患者，但MAA阳性与肌肉外疾病活动无显著关联。
MSA阳性有助于IIM的诊断。MSA阳性与更高的肌肉外疾病活动相关。改善MSA的临床应用可能会加强对IIM患者的个体化治疗。要点 • 在本文中，我们探讨了肌炎自身抗体与炎性肌病的诊断和疾病活动之间的关系。 • 阳性的肌炎特异性自身抗体与诊断的确立及更高的肌肉外疾病活动相关。 • 因此，更广泛地应用肌炎自身抗体可能是进一步疾病评估和研究的关键。
