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Anti-transcriptional intermediary factor 1 gamma antibodies in cancer-associated myositis: a longitudinal study

1, 2, 3, 4, 5, 6, 7, 8, 9

  1. Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden. lara.dani@karolinska.se
  2. Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
  3. Department of Immunology, Sant Pau Hospital, Barcelona, Spain.
  4. Rheumatology Unit, Vall d'Hebron General Hospital, Universitat Autònoma de Barcelona, Spain.
  5. Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
  6. Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
  7. Department of Internal Medicine, Vall d'Hebron General Hospital, Universitat Autònoma de Barcelona, Spain.
  8. Department of Internal Medicine, Vall d'Hebron General Hospital, Universitat Autònoma de Barcelona, Spain.
  9. Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.

CER11700 Submission on line
Full Papers

Rheumatology Article
Rheumatology Article

 

Abstract

OBJECTIVES:
To investigate anti-TIF1-γ antibodies in longitudinally followed patients with myositis and cancer.
METHODS:
Serum levels of anti-TIF1-γ antibodies at different time-points in relation to myositis and cancer diagnosis were analysed by ELISA in 79 patients from a Swedish cohort with polymyositis (PM) and dermatomyositis (DM) and a Spanish cohort restricted to DM patients. Anti-TIF1-γ positive and negative patients were compared with Fisher’s exact test, student t-tests and Wilcoxon test.
RESULTS:
Thirty-six patients (17 from cohort 1 and 19 from cohort 2) with myositis and cancer were anti-TIF1-γ antibody positive; all had DM. In 88% of anti-TIF1-γ positive patients, cancer was diagnosed within 3 years from DM diagnosis compared to 63% in anti-TIF1-γ negative. Four DM patients, anti-TIF1-γ positive at cancer diagnosis had positive serum samples even antedating cancer diagnosis up to five years. In cohort 1 the median (interquartile range) antibody level was higher, 2.13 au (1.82–2.15), in the seven patients who died <1 year after cancer diagnosis, compared to the seven that died >1 year after cancer diagnosis, 1.34 au (0.92–1.59), (p=0.004). Three patients were still alive and in remission from cancer and DM 14–16 years after cancer treatment of whom two became negative for anti-TIF1-γ antibodies. In the second cohort remission of cancer coincided with remission of DM and low or negative serum levels of autoantibodies.
CONCLUSIONS:
Anti-TIF1-γ antibodies may be detected before clinical symptoms of cancer and may disappear after successful treatment of cancer with remission of DM supporting DM being a paramalignant phenomenon.

PMID: 31365334 [PubMed]

Received: 03/09/2018 - Accepted : 18/03/2019 - In Press: 30/07/2019