Screening for Myositis Antibodies in Idiopathic Interstitial Lung Disease

Fidler, Lee; Doubelt, Irena; Kandel, Sonja; Fisher, J.H.; Mittoo, Shikha; Shapera, Shane

doi:10.1007/s00408-019-00212-9

Cited by 23 publications

(21 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, targets of these autoantibodies might actually participate in the disease process, culminating in pulmonary fibrosis. Although in general, the treatment response for immunosuppressive drugs is better in CTD-ILDs compared with other ILDs [5][6][7][8][9][10], one can speculate whether specific treatment regiments should be reconsidered in antibody positive ILD without established CTD. Recently, the use of anti-fibrotic therapy has been successfully demonstrated in Ssc-IP and progressive fibrosing ILDs [49,50].…”

Section: Discussionmentioning

confidence: 99%

“…Interstitial lung diseases (ILDs) are a heterogeneous group of diffuse parenchymal lung disorders, characterized by inflammation or fibrosis of the pulmonary interstitium. ILDs can be idiopathic or secondary to known causes including connective tissue diseases (CTDs) [1][2][3][4][5]. It is challenging to distinguish CTD-ILD from other ILDs as clinical, functional, radiological, and pathological characteristics can be similar [6].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, an interstitial pneumonia (IP) may be the first or single clinical manifestation of an underlying CTD [4,6]. In general, outcomes on treatment response to immunosuppressive therapy and survival are better in CTD-ILD compared to the majority of ILDs without established CTD [5][6][7][8][9][10]. Thus, discriminating these conditions in the diagnostic work-up is essential.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of Novel Myositis Autoantibodies in a Large Cohort of Patients with Interstitial Lung Disease

Moll

Platenburg

Platteel

et al. 2020

JCM

View full text Add to dashboard Cite

Connective tissue diseases (CTDs) are an important secondary cause of interstitial lung disease (ILD). If a CTD is suspected, clinicians are recommended to perform autoantibody testing, including for myositis autoantibodies. In this study, the prevalence and clinical associations of novel myositis autoantibodies in ILD are presented. A total of 1194 patients with ILD and 116 healthy subjects were tested for antibodies specific for Ks, Ha, Zoα, and cN1A with a line-blot assay on serum available at the time of diagnosis. Autoantibodies were demonstrated in 63 (5.3%) patients and one (0.9%) healthy control (p = 0.035). Autoantibodies were found more frequently in females (p = 0.042) and patients without a histological and/or radiological usual interstitial pneumonia (UIP; p = 0.010) and a trend towards CTD-ILDs (8.4%) was seen compared with other ILDs (4.9%; p = 0.090). The prevalence of antibodies specific for Ks, Ha, Zoα, and cN1A was, respectively, 1.3%, 2.0%, 1.4%, and 0.9% in ILD. Anti-Ha and Anti-Ks were observed in males with unclassifiable idiopathic interstitial pneumonia (unclassifiable IIP), hypersensitivity pneumonitis (HP), and various CTD-ILDs, whereas anti-cN1A was seen in females with antisynthetase syndrome (ASS), HP, and idiopathic pulmonary fibrosis (IPF). Anti-Zoα was associated with CTD-ILD (OR 2.5; 95%CI 1.11–5.61; p = 0.027). In conclusion, a relatively high prevalence of previously unknown myositis autoantibodies was found in a large cohort of various ILDs. Our results contribute to the awareness that circulating autoantibodies can be found in ILDs with or without established CTD. Whether these antibodies have to be added to the standard set of autoantibodies analysed in conventional myositis blot assays for diagnostic purposes in clinical ILD care requires further study.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of Novel Myositis Autoantibodies in a Large Cohort of Patients with Interstitial Lung Disease

Moll

Platenburg

Platteel

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Previous studies had indicated the potential importance of MSA in the diagnosis and prognosis of IP. 26.7% (44/165) of patients with IP on their initial diagnosis were positive for myositis autoantibodies [32]. The overall survival of IP with anti-ARS was higher than that of idiopathic pulmonary brosis (IPF).…”

Section: Discussionmentioning

confidence: 99%

Phenotypic Clusters and Survival Analyses in Interstitial Pneumonia with Myositis-Specific Autoantibodies

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background: Interstitial pneumonia (IP) is one of the common pulmonary complications of idiopathic inflammatory myopathy (IIM), among which myositis-specific autoantibodies (MSA) are specific for IIM diagnosis and prognosis. However, IP patients with MSA (MSA-IP) have not been well described. The study aimed to explore the phenotypic clusters and prognosis of MSA-IP patients.Methods: A total of 124 MSA-IP patients were prospectively enrolled for analysis. Serum MSA were detected using immunoprecipitation. Radiographic patterns of IP were determined according to the classification of idiopathic IPs. The clusters of MSA-IP patients were identified using cluster analysis. Potential risk factors of acute onset and short-term prognosis were also analyzed. Results: There were four clusters of MSA-IP patients. Cluster 1 patients were elders with chronic onset and usual interstitial pneumonia pattern on CT scan. Cluster 2 patients were all positive for anti-aminoacyl-tRNA antibodies, predominantly females and had frequent respiratory symptoms. Patients of cluster 3 showed multi-system involvements with nonspecific interstitial pneumonia pattern. Patients of cluster 4 had severe respiratory symptoms with anti-MDA5. The patients of cluster 3 (OR 6.682, 95% CI 1.560–28.622, P=0.011) or cluster 4 (OR 6.057, 95% CI 1.715–21.388, P=0.005) were susceptible to acute onset. The patients of cluster 4 were prone to disease progression (HR 2.711, 95% CI 1.128–6.519, P=0.034), which was consistent with the Kaplan–Meier curves.Conclusions: Four distinctive clusters were determined by cluster analysis suggesting the characteristics, serological antibodies and prognosis of MSA-IP.

show abstract

“…Previous studies have indicated the potential importance of MSAs in diagnosing and predicting the prognosis of IP. A cohort study showed that 26.7% (44/165) of patients with IP at the initial diagnosis were positive for myositis autoantibodies [32]. In addition, the overall survival rate of patients with IP and anti-ARS antibodies was higher than that of patients with idiopathic pulmonary brosis (IPF), and the survival rate of IP with anti-ARS antibodies was similar regardless of whether IIM was diagnosed [20].…”

Section: Discussionmentioning

confidence: 99%

Phenotypic clusters and survival analyses in interstitial pneumonia with myositis-specific autoantibodies

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Interstitial pneumonia (IP) is one of the common pulmonary complications of idiopathic inflammatory myopathy (IIM), among which myositis-specific autoantibodies (MSAs) are specific for diagnosing and predicting the prognosis of IIM. However, IP patients with MSAs (MSA-IP) have not been well described. The study aimed to explore the phenotypic clusters and prognosis of MSA-IP patients. Methods A total of 124 MSA-IP patients were prospectively enrolled for analysis. Serum MSAs were detected using immunoprecipitation. Radiographic patterns of IP were determined according to the classification of idiopathic IPs. Clusters of MSA-IP patients were identified using cluster analysis. Potential risk factors for acute-onset disease and short-term prognoses were also analysed. Results There were four clusters of MSA-IP patients. Cluster 1 patients were elderly with chronic onset and a usual interstitial pneumonia pattern on computed tomography. Cluster 2 patients were all positive for anti-aminoacyl-tRNA antibodies, were predominantly female and had frequent respiratory symptoms. Patients in cluster 3 showed multi-system involvement with a nonspecific interstitial pneumonia pattern. Patients in cluster 4 had severe respiratory symptoms with anti-MDA5 antibodies. The patients in cluster 3 (OR 6.682, 95% CI 1.560–28.622, P =0.011) and cluster 4 (OR 6.057, 95% CI 1.715–21.388, P =0.005) were susceptible to acute-onset disease. The patients in cluster 4 were prone to disease progression (HR 2.711, 95% CI 1.128–6.519, P =0.034), which was consistent with the Kaplan–Meier curves. Conclusions Four distinctive clusters were determined by cluster analysis, suggesting the characteristics, serological antibodies and prognosis of patients with MSA-IP.

show abstract

Screening for Myositis Antibodies in Idiopathic Interstitial Lung Disease

Cited by 23 publications

References 20 publications

Prevalence of Novel Myositis Autoantibodies in a Large Cohort of Patients with Interstitial Lung Disease

Prevalence of Novel Myositis Autoantibodies in a Large Cohort of Patients with Interstitial Lung Disease

Phenotypic Clusters and Survival Analyses in Interstitial Pneumonia with Myositis-Specific Autoantibodies

Phenotypic clusters and survival analyses in interstitial pneumonia with myositis-specific autoantibodies

Contact Info

Product

Resources

About