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Article Dans Une Revue Seminars in Arthritis and Rheumatism Année : 2022

Myositis-specific autoantibodies in clinical practice: Improving the performance of the immunodot

Résumé

Background/objectives: Idiopathic inflammatory myopathies (IIM) diagnosis and sub-classification can be improved by detection of myositis specific antibodies (MSA) as a first step in diagnosis. However, when using semi-quantitative immunodots for MSA detection, clinical assay performance needs to be improved. Methods: A retrospective study was done for the "myositis" and "synthetase" immunodots (SRP, NXP2, TIF1gamma, SAE1/2, Mi2, MDA5, Jo1, PL7, PL12, EJ, OJ, KS, ZO and HA) from D-Tek used for 270 patients who had tested positive for MSA in a tertiary laboratory hospital. Results: Results from this analysis revealed: (i) none of the 60 healthy controls presented MSA; (ii) a low assay specificity among patients who tested positive for MSA, 128/270 (47%) were labeled IIM based on the manufacturer's recommended threshold; (iii) in non-IIM patients (53%), the MSA spectrum overlaps predominantly with other autoimmune diseases or idiopathic interstitial lung disease; and (iv) use of a clinical cut-off improves assay specificity for anti-SRP, anti-NXP2, anti-MDA5, anti-Jo1 and anti-PL7 Abs. Conclusion: Determining the clinical threshold of the semi-quantitative immunodot assay for MSA is effective for improving its capacity to discriminate IIM from non-IIM and, when IIM diagnosis is excluded, another autoimmune disease or an idiopathic interstitial lung disease should be considered in front of a positive MSA.
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Dates et versions

hal-04019868 , version 1 (08-03-2023)

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E. Bories, F. Fortenfant, G. Pugnet, Y. Renaudineau, C. Bost. Myositis-specific autoantibodies in clinical practice: Improving the performance of the immunodot. Seminars in Arthritis and Rheumatism, 2022, 55, pp.151998. ⟨10.1016/j.semarthrit.2022.151998⟩. ⟨hal-04019868⟩
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