Rheumatology Advance Access originally published online on May 25, 2006
Rheumatology 2007 46(1):25-28; doi:10.1093/rheumatology/kel161
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Identification of a novel autoantibody reactive with 155 and 140 kDa nuclear proteins in patients with dermatomyositis: an association with malignancy
Department of Dermatology, Kanazawa University Graduate School of Medical Science, Ishikawa, 1Department of Dermatology, Jikei University School of Medicine, Tokyo, 2Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, 3Department of Dermatology, Ogaki Municipal Hospital, Gifu and 4Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Correspondence to: M. Fujimoto, Department of Dermatology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan. E-mail: fujimoto-m{at}umin.ac.jp
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Abstract |
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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 35S-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.
KEY WORDS: Dermatomyositis, Myositis-specific autoantibodies, Malignancy, Interstitial lung disease
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