The IgG2 Isotype of Anti–Transcription Intermediary Factor 1γ Autoantibodies Is a Biomarker of Cancer and Mortality in Adult Dermatomyositis
2 Physiopathologie et biothérapies des maladies inflammatoires et autoimmunes
3 LBMC UMR 5239 - Laboratoire de biologie et modélisation de la cellule
4 Hôpital Edouard Herriot [CHU - HCL]
5 INM - Institut des Neurosciences de Montpellier
6 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
7 Service de Médecine Interne [CHU Rouen]
8 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
9 Physiopathologie des arthrites
10 Service de médecine interne
11 LIRIC - Lille Inflammation Research International Center - U 995
12 IMRB - Institut Mondor de Recherche Biomédicale
13 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
14 GPMCND - Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques
15 DEPARTAMENT DE QUíMICA ORGàNICA - Facultat de Química
16 SU FM - Sorbonne Université - Faculté de Médecine
17 Service de Dermatologie et Médecine Interne [Pointe-à-Pitre, Guadeloupe]
- Fonction : Auteur
- PersonId : 1267501
- ORCID : 0000-0002-7020-1954
- IdRef : 195497724
- Fonction : Auteur
- PersonId : 907533
- Fonction : Auteur
- PersonId : 944960
- Fonction : Auteur
- PersonId : 948651
- ORCID : 0000-0002-1601-4795
- IdRef : 067331270
- Fonction : Auteur
- Fonction : Auteur
- PersonId : 1366882
- IdHAL : erichachulla
- ORCID : 0000-0001-7432-847X
- IdRef : 031788866
- Fonction : Auteur
- Fonction : Auteur
- PersonId : 1238060
- ORCID : 0000-0002-2530-7346
- IdRef : 081296606
- Fonction : Auteur
- Fonction : Auteur
- PersonId : 977142
- IdHAL : yves-allenbach
- ORCID : 0000-0002-3185-7993
- IdRef : 160377293
- Fonction : Auteur
- PersonId : 1007551
- IdHAL : olivier-benveniste
- ORCID : 0000-0002-1167-5797
- IdRef : 160377072
- Fonction : Auteur
- PersonId : 1255118
- ORCID : 0000-0003-1679-8005
- IdRef : 108964000
- Fonction : Auteur
- PersonId : 761768
- ORCID : 0000-0002-7591-307X
- IdRef : 077103610
Résumé
Objective: Anti-transcription intermediary factor 1γ (anti-TIF1γ) antibodies are the main predictors of cancer in dermatomyositis (DM). Yet, a substantial proportion of anti-TIF1γ-positive DM patients do not develop cancer. This study was undertaken to identify biomarkers to better evaluate the risk of cancer and mortality in DM. Methods: This multicenter study was conducted in adult anti-TIF1γ-positive DM patients from August 2013 to August 2017. Anti-TIF1γ autoantibody levels and IgG subclasses were identified using a newly developed quantitative immunoassay. Age, sex, DM signs and activity, malignancy, and creatine kinase (CK) level were recorded. Risk factors were determined by univariate and multivariate analysis according to a Cox proportional hazards regression model. Results: Among the 51 adult patients enrolled (mean ± SD age 61 ± 17 years; ratio of men to women 0.65), 40 (78%) had cancer and 21 (41%) died, with a mean ± SD survival time of 10 ± 6 months. Detection of anti-TIF1γ IgG2 was significantly associated with mortality (P = 0.0011) and occurrence of cancer during follow-up (P < 0.0001), with a 100% positive predictive value for cancer when the mean fluorescence intensity of anti-TIF1γ IgG2 was >385. None of the patients developed cancer after 24 months of follow-up. Univariate survival analyses showed that mortality was also associated with age >60 years (P = 0.0003), active DM (P = 0.0042), cancer (P = 0.0031), male sex (P = 0.011), and CK level >1,084 units/liter (P = 0.005). Multivariate analysis revealed that age >60 years (P = 0.015) and the presence of anti-TIF1γ IgG2 (P = 0.048) were independently associated with mortality. Conclusion: Our findings indicate that anti-TIF1γ IgG2 is a potential new biomarker of cancer that should be helpful in identifying the risk of mortality in anti-TIF1γ-positive DM patients.