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The indirect immunofluorescence assay autoantibody profiles of myositis patients without known myositis-specific autoantibodies


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

 

  1. National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, and Johns Hopkins University School of Medicine, Baltimore, MD, USA. maria.casal-dominguez@nih.gov
  2. National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD; Johns Hopkins University School of Medicine, Baltimore, MD, USA; and Faculty of Health Sciences and Faculty of Computer Science, Multimedia and Telecommunications, Universitat Oberta de Catalunya, Barcelona, Spain.
  3. National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
  4. Vall d’Hebron Hospital, Barcelona, Spain.
  5. Vall d’Hebron Hospital, Barcelona, Spain.
  6. Sant Pau Hospital, Barcelona, Spain.
  7. National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.
  8. Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  9. National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, and Johns Hopkins University School of Medicine, Baltimore, MD, USA. andrew.mammen@nih.gov

for the Johns Hopkins Myositis Center Group

CER13283
2021 Vol.39, N°3
PI 0519, PF 0524
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PMID: 32896249 [PubMed]

Received: 04/03/2020
Accepted : 11/05/2020
In Press: 03/09/2020
Published: 21/05/2021

Abstract

OBJECTIVES:
The indirect immunofluorescence assay (IIFA) is used to screen for the presence of autoantibodies. Our objective was to determine the prevalence and clinical features of IIFA positive myositis patients without known myositis-specific autoantibodies (MSA).
METHODS:
Sera from healthy comparators (HC) and patients with dermatomyositis (DM), inclusion body myositis (IBM), and polymyositis (PM) with no detectable MSA were tested by IIFA on HEp-2 cells. The pattern of positivity was classified according to the International Consensus on Antinuclear Antibody Patterns. The prevalence and frequency of each IIFA pattern were compared between the different groups.
RESULTS:
Sera from 100 HC, 71 DM, 53 IBM, and 69 PM subjects were included in the study. The IIFA was positive in 35% HC compared to 66% DM (p<0.001), 49% IBM, and 64% (p<0.001) PM sera. Among IIFA positive sera, the staining was moderate or intense in 43% HC compared to 79% DM (p<0.001) but just 54% IBM, and 52% PM sera. IIFA positivity was predominantly nuclear in all groups (all >69%). The most common pattern in myositis patients was fine speckled with no differences between groups. In general, IIFA positive and negative DM patients showed similar clinical features and disease activity.
CONCLUSIONS:
Half of MSA-negative DM patients have moderate/strong IIFA positivity, predominantly with a fine speckled pattern. In contrast, MSA-negative PM, IBM, and healthy comparators are more often weakly positive for IIFA. These findings suggest that unidentified autoantibodies are more likely to exist in DM patients than in the other myositis groups.

Rheumatology Article