Mugii Naoki, Hamaguchi Yasuhito, Horii Motoki, Fushida Natsumi, Ikeda Tomoyuki, Oishi Kyosuke, Yahata Tetsutarou, Someya Fujiko, Matsushita Takashi
Department of Rehabilitation, Kanazawa University Hospital.
Department of Dermatology.
Rheumatology (Oxford). 2023 Mar 1;62(3):1326-1334. doi: 10.1093/rheumatology/keac401.
To assess the longitudinal changes in nailfold videocapillaroscopy (NVC) in patients expressing myositis-specific autoantibodies [anti-aminoacyl-tRNA synthetase (ARS), anti-transcriptional intermediary factor 1 (TIF1), and anti-melanoma differentiation-associated gene 5 (MDA5)].
This study was performed retrospectively, at a single site, on an observational cohort. Seventy-one idiopathic inflammatory myopathy patients were included (25 patients expressed anti-MDA5 Abs, 24 patients expressed anti-TIF1 Abs, and 22 patients expressed anti-ARS Abs). NVC findings included giant, enlarged, and reduced capillaries, haemorrhages, capillary ramification, disorganization of the vascular array, and capillary loss. NVC findings were compared from baseline to after disease activity stabilization.
The frequency of enlarged capillaries at baseline was different among the three groups, and was significantly higher in patients with anti-TIF1 Abs compared with those with anti-ARS Abs (88% vs 55%, P < 0.05). Reduced capillaries were significantly increased in patients with anti-TIF1 Abs compared with those with anti-MDA5 (96% vs 44%, P < 0.0001) or anti-ARS Abs (96% vs 50%, P < 0.0005). Both enlarged and reduced capillaries improved after stabilization in patients with anti-MDA5 Abs (P < 0.0001 and P < 0.05, respectively). These improvements were not observed in patients expressing anti-TIF1 and anti-ARS Abs. However, a significant reduction in haemorrhages was observed in all three groups (P < 0.0001 for each group).
The results of this study demonstrate that longitudinal changes in NVC findings may vary depending on myositis-specific Ab expression. Therefore, it is crucial to assess individual NVC findings separately, as each finding may impact disease activity in a different manner.
评估表达肌炎特异性自身抗体[抗氨酰tRNA合成酶（ARS）、抗转录中介因子1（TIF1）和抗黑色素瘤分化相关基因5（MDA5）]的患者甲襞视频毛细血管镜检查（NVC）的纵向变化。
本研究在单一中心对一个观察性队列进行回顾性研究。纳入71例特发性炎性肌病患者（25例表达抗MDA5抗体，24例表达抗TIF1抗体，22例表达抗ARS抗体）。NVC检查结果包括巨大、扩张和缩小的毛细血管、出血、毛细血管分支、血管排列紊乱和毛细血管缺失。比较疾病活动稳定前后的NVC检查结果。
三组患者基线时扩张毛细血管的频率不同，抗TIF1抗体患者的扩张毛细血管频率显著高于抗ARS抗体患者（88%对55%，P<0.05）。与抗MDA5抗体患者（96%对44%，P<0.0001）或抗ARS抗体患者（96%对50%，P<0.0005）相比，抗TIF1抗体患者缩小的毛细血管显著增加。抗MDA5抗体患者病情稳定后，扩张和缩小的毛细血管均有所改善（分别为P<0.0001和P<0.05）。表达抗TIF1和抗ARS抗体的患者未观察到这些改善。然而，三组患者的出血均显著减少（每组P<0.0001）。
本研究结果表明，NVC检查结果的纵向变化可能因肌炎特异性抗体表达而异。因此，分别评估个体NVC检查结果至关重要，因为每个结果可能以不同方式影响疾病活动。
