Identification of a novel autoantibody reactive with 155 and 140 kDa nuclear proteins in patients with dermatomyositis: an association with malignancy
Identification of a novel autoantibody reactive with 155 and 140 kDa nuclear proteins in patients with dermatomyositis: an association with malignancy
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DOI：
10.1093/rheumatology/kel161
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发表时间：
2007-01-01
期刊：
影响因子：
5.5
通讯作者：
Takehara, K.
中科院分区：
文献类型：
--
作者：
Kaji, K.;Fujimoto, M.;Takehara, K.
Objective.肌炎特异性自身抗体（MSA）在皮肌炎（DM）和多发性肌炎（PM）的诊断、确定临床亚型和预测预后方面具有重要意义。在这项研究中，我们确定了一种新的MSA反应与155和140 kDa的核蛋白[抗155/140抗体（Ab）]，并确定了糖尿病患者的临床特征，阳性的这种自身抗体（autoAb）。用免疫沉淀法检测了52例日本DM、9例PM、48例系统性红斑狼疮（SLE）、126例系统性硬化症和18例特发性间质性肺炎患者的血清。阳性血清经免疫耗竭和免疫荧光染色进一步鉴定。52例日本DM患者中有7例（13%）从S-35标记的K562白血病细胞提取物中免疫沉淀出155和140 kDa蛋白。SLE、系统性硬化症或特发性间质性肺炎患者以及健康对照者均未检测到该自身抗体。抗155/140抗体阳性患者出现日形皮疹、戈特朗丘疹或征和鞭状红斑的频率显著高于阴性患者。值得注意的是，内部恶性肿瘤在阳性组中的发生率显著高于阴性组（71比11%; P < 0.005）。与此相反，这些自身抗体阳性的患者均未发生间质性肺病。这种新的MSA与癌症相关的DM相关，并可作为该特定亚群的诊断血清学标记物。
Objective. Myositis-specific autoantibodies (MSAs) are a useful tool in diagnosis, defining clinical subsets and predicting prognosis of dermatomyositis (DM) and polymyositis (PM). In this study, we identified a novel MSA reactive with 155 and 140 kDa nuclear proteins [anti-155/140 antibody (Ab)] and determined the clinical feature of DM patients positive for this autoantibody (autoAb).Methods. Sera from 52 Japanese patients with DM, 9 with PM, 48 with systemic lupus erythematosus (SLE), 126 with systemic sclerosis and 18 with idiopathic interstitial pneumonia were examined by immunoprecipitation assays. Positive sera were further characterized by immunodepletion and immunofluorescence staining.Results. Seven of the 52 (13%) Japanese patients with DM immunoprecipitated 155 and 140 kDa proteins from S-35-labelled K562 leukaemia cell extract. No patients with SLE, systemic sclerosis or idiopathic interstitial pneumonia as well as healthy controls were positive for this autoAb. Patients with anti-155/140 Ab developed heliotrope rash, Gottron's papules or sign and flagellate erythema significantly more frequently than those negative. Notably, internal malignancy was found at significantly higher frequency in those positive than those negative (71 vs 11%; P < 0.005). In contrast, none of these patients positive for this autoAb had interstitial lung disease.Conclusions. This novel MSA is associated with cancer-associated DM and may serve as a diagnostic serological marker for this specific subset.