Coexistence of anti-HMGCR and anti-MDA5 identified by an unlabeled immunoprecipitation assay in a chinese patient cohort with myositis

Coexistence of anti-HMGCR and anti-MDA5 identified by an unlabeled immunoprecipitation assay in a chinese patient cohort with myositis
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通过未标记的免疫沉淀测定在中国肌炎患者队列中发现抗 HMGCR 和抗 MDA5 共存

DOI:
10.1097/md.0000000000013236
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发表时间:
2018-11-01
期刊:
影响因子:
1.6
通讯作者:
Xiao, Xianzhong
Xiao, Xianzhong
中科院分区:
医学4区
文献类型:
--
作者:
Huang, Li;Wang, Li;Xiao, Xianzhong

文献摘要

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肌炎特异性自身抗体是重要的诊断和预后标志物。本研究的目的是应用新型无标记免疫沉淀(IP)法和免疫印迹法检测中国肌炎患者抗3-羟基-3-甲基戊二酰辅酶A还原酶(抗-HMGCR)抗体,以明确抗-HMGCR阳性患者的特点。在本研究中,我们建立了一种新的无标记IP法和免疫印迹法检测抗HMGCR。对181例中国肌炎患者进行了抗HMGCR抗体筛查。181例患者中有12例血清抗HMGCR阳性。我们队列中抗HMGCR自身抗体的流行率约为6.6%。在4例有特征性皮疹和间质性肺疾病(ILD)的患者中,意外地发现抗HMGCR和抗黑色素瘤分化相关蛋白(抗MDA5)共存,但没有肌无力和血清肌酸激酶(CK)水平升高。其他抗MDA5抗体阴性的抗HMGCR阳性患者表现为严重的近端肌肉无力。抗-HMGCR阳性患者血清CK和乳酸脱氢酶(LDH)水平显著高于抗体阴性患者(P
Myositis-specific autoantibodies are important diagnostic and prognostic markers. The aim of our study is to detect anti-3-hydroxy 3-methylutaryl coenzyme A reductase (anti-HMGCR) antibody using novel unlabeled immunoprecipitation (IP) assay and immunoblotting in Chinese patients with myositis and to clarify the features of anti-HMGCR-positive patients. In the present study, we established novel unlabeled IP assay and immunoblotting of HMGCR C-terminus for anti-HMGCR detection. The presence of anti-HMGCR was screened in 181 Chinese patients with myositis. The sera from 12 of 181 patients were positive for anti-HMGCR. The prevalence of anti-HMGCR autoantibody in our cohorts is about 6.6%. Unexpected, coexistence of anti-HMGCR and anti-melanoma differentiation-associated protein (anti-MDA5) were identified in 4 patients with characteristic rash and interstitial lung disease (ILD), but without myasthenia and elevated serum creatine kinase (CK) levels. Other anti-HMGCR positive patients without anti-MDA5 presented with severe proximal muscle weakness. Mean serum CK levels and lactate dehydrogenase (LDH) were significantly higher in anti-HMGCR-positive patients than in antibody-negative patients (P