Detection of Myositis Autoantibodies by Multi-Analytic Immunoassays in a Large Multicenter Cohort of Patients with Definite Idiopathic Inflammatory Myopathies
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Published:2023-09-28
Issue:19
Volume:13
Page:3080
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ISSN:2075-4418
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Container-title:Diagnostics
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language:en
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Short-container-title:Diagnostics
Author:
Ghirardello Anna1, Gatto Mariele12ORCID, Franco Chiara1ORCID, Zanatta Elisabetta1, Padoan Roberto1ORCID, Ienna Luana1, Gallo Nicoletta3, Zen Margherita1ORCID, Lundberg Ingrid E.4ORCID, Mahler Michael5, Doria Andrea1ORCID, Iaccarino Luca1
Affiliation:
1. Rheumatology Unit, Department of Medicine-DIMED, University Hospital of Padova, 35128 Padova, Italy 2. Rheumatology Unit, Department of Clinical and Biological Sciences, Mauriziano Hospital, University of Turin, 10124 Turin, Italy 3. Unit of Laboratory Medicine, Department of Medicine-DIMED, University Hospital of Padova, 35128 Padova, Italy 4. Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet, 171 77 Stockholm, Sweden 5. Werfen Autoimmunity, San Diego, CA 92131, USA
Abstract
Background: The usefulness of myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs) for the assessment of idiopathic inflammatory myopathies (IIMs) is acknowledged, but laboratory standardization remains a challenge. We detected MSAs/MAAs by multi-analytic line immunoassay (LIA) and particle-based multi-analyte technology (PMAT) in a multicenter cohort of patients with IIMs. Methods: We tested the sera from 411 patients affected with definite IIM, including 142 polymyositis (PM), 147 dermatomyositis (DM), 19 cancer-associated myositis, and 103 overlap myositis syndrome (OM), and from 269 controls. MSAs/MAAs were determined by 16Ags LIA in all sera, and anti-HMGCR by ELISA in 157/411 IIM sera and 91/269 control sera. The analytical specificity of LIA/HMGCR ELISA was compared with that of PMAT in 89 MSA+ IIM sera. Results: MSAs/MAAs were positive in 307/411 (75%) IIM patients and 65/269 (24%) controls by LIA (Odds Ratio 9.26, 95% CI 6.43–13.13, p < 0.0001). The sensitivity/specificity of individual MSAs/MAAs were: 20%/100% (Jo-1), 3%/99.3% (PL-7), 4%/98.8% (PL-12), 1%/100% (EJ), 0.7%/100% (OJ), 9%/98% (SRP), 5.6%/99.6% (TIF1γ), 4.6%/99.6% (MDA5), 8%/96% (Mi-2), 1.5%/98% (NXP2), 1.7%/100% (SAE1), 4%/92% (Ku), 8.5%/99% (PM/Scl-100), 8%/96% (PM/Scl-75), and 25.5%/79% (Ro52). Anti-HMGCR was found in 8/157 (5%) IIM patients and 0/176 (0%) controls by ELISA (p = 0.007). Concordance between LIA/HMGCR ELISA and PMAT was found in 78/89 (88%) samples. Individual MSAs detected by LIA were associated with IIM subsets: Jo-1 with PM and OM, PL-12 with OM, Mi-2, TIF1γ, and MDA5 with DM, SRP with PM, and PM/Scl-75/100 with OM (p < 0.001 for all). Conclusions: Since MSAs are mostly mutually exclusive, multi-specific antibody profiling seems effective for a targeted clinical-serologic approach to the diagnosis of IIMs.
Funder
Italian Ministry for Education, University and Research
Subject
Clinical Biochemistry
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