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Anti-transcriptional intermediary factor 1 gamma antibodies in cancer-associated myositis: a longitudinal study
L. Dani1, M. Holmqvist2, M.A. Martínez3, E. Trallero-Araguas4, M. Dastmalchi5, J. Svensson6, M. Labrador-Horrillo7, A. Selva-O'callaghan8, I.E. Lundberg9
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden. lara.dani@karolinska.se
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
- Department of Immunology, Sant Pau Hospital, Barcelona, Spain.
- Rheumatology Unit, Vall d'Hebron General Hospital, Universitat Autònoma de Barcelona, Spain.
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
- Department of Internal Medicine, Vall d'Hebron General Hospital, Universitat Autònoma de Barcelona, Spain.
- Department of Internal Medicine, Vall d'Hebron General Hospital, Universitat Autònoma de Barcelona, Spain.
- Division of Rheumatology, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden.
CER11700
2020 Vol.38, N°1
PI 0067, PF 0073
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PMID: 31365334 [PubMed]
Received: 03/09/2018
Accepted : 18/03/2019
In Press: 30/07/2019
Published: 06/02/2020
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.
