Diagnosis of myositis-associated interstitial lung disease : Utility of the myositis autoantibody line immunoassay
Copyright © 2021 Elsevier Ltd. All rights reserved..
OBJECTIVES: The detection of myositis autoantibodies (MA) in patients with interstitial lung disease (ILD) has major implications for diagnosis and management, especially amyopathic and forme frustes of idiopathic inflammatory myositis-associated ILD (IIM-ILD). Use of the MA line immunoblot assay (MA-LIA) in non-rheumatological cohorts remains unvalidated. We assessed the diagnostic performance of the MA-LIA and explored combined models with clinical variables to improve identification of patients with IIM-ILD.
METHODS: Consecutive patients referred to a specialist ILD clinic, with ILD-diagnosis confirmed at multidisciplinary meeting, and MA-LIA performed within six months of baseline were included. Pre-specified MA-LIA thresholds were evaluated for IIM-ILD diagnosis.
RESULTS: A total 247 ILD patients were included (IIM-ILD n = 12, non-IIM connective tissue disease-associated ILD [CTD-ILD] n = 52, idiopathic interstitial pneumonia [IIP] n = 115, other-ILD n = 68). Mean age was 64.8 years, with 45.3% female, mean FVC 75.5% and DLCO 59.2% predicted. MA were present in 13.8% overall and 83.3% of IIM-ILD patients. The most common MA in IIM-ILD and non-IIM ILD patients were anti-Jo-1 (prevalence 40%) and anti-PMScl (29.2%) autoantibodies respectively. The pre-specified low-positive threshold (>10 signal intensity) had the highest discriminative capacity for IIM-ILD (AUC 0.86). Combining MA-LIA with age, gender, clinical CTD-manifestations and an overlap non-specific interstitial pneumonia/organising pneumonia pattern on HRCT improved discrimination for IIM-ILD (AUC 0.96).
CONCLUSION: The MA-LIA is useful to support a diagnosis of IIM-ILD as a complement to multi-disciplinary ILD assessment. Clinical interpretation is optimised by consideration of the strength of the MA-LIA result together with clinical and radiological features of IIM-ILD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:187 |
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| Enthalten in: |
Respiratory medicine - 187(2021) vom: 01. Okt., Seite 106581 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jee, Adelle S [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 08.02.2022 Date Revised 08.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.rmed.2021.106581 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM329971301 |
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| 100 | 1 | |a Jee, Adelle S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Diagnosis of myositis-associated interstitial lung disease |b Utility of the myositis autoantibody line immunoassay |
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| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 08.02.2022 | ||
| 500 | |a Date Revised 08.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Ltd. All rights reserved. | ||
| 520 | |a OBJECTIVES: The detection of myositis autoantibodies (MA) in patients with interstitial lung disease (ILD) has major implications for diagnosis and management, especially amyopathic and forme frustes of idiopathic inflammatory myositis-associated ILD (IIM-ILD). Use of the MA line immunoblot assay (MA-LIA) in non-rheumatological cohorts remains unvalidated. We assessed the diagnostic performance of the MA-LIA and explored combined models with clinical variables to improve identification of patients with IIM-ILD | ||
| 520 | |a METHODS: Consecutive patients referred to a specialist ILD clinic, with ILD-diagnosis confirmed at multidisciplinary meeting, and MA-LIA performed within six months of baseline were included. Pre-specified MA-LIA thresholds were evaluated for IIM-ILD diagnosis | ||
| 520 | |a RESULTS: A total 247 ILD patients were included (IIM-ILD n = 12, non-IIM connective tissue disease-associated ILD [CTD-ILD] n = 52, idiopathic interstitial pneumonia [IIP] n = 115, other-ILD n = 68). Mean age was 64.8 years, with 45.3% female, mean FVC 75.5% and DLCO 59.2% predicted. MA were present in 13.8% overall and 83.3% of IIM-ILD patients. The most common MA in IIM-ILD and non-IIM ILD patients were anti-Jo-1 (prevalence 40%) and anti-PMScl (29.2%) autoantibodies respectively. The pre-specified low-positive threshold (>10 signal intensity) had the highest discriminative capacity for IIM-ILD (AUC 0.86). Combining MA-LIA with age, gender, clinical CTD-manifestations and an overlap non-specific interstitial pneumonia/organising pneumonia pattern on HRCT improved discrimination for IIM-ILD (AUC 0.96) | ||
| 520 | |a CONCLUSION: The MA-LIA is useful to support a diagnosis of IIM-ILD as a complement to multi-disciplinary ILD assessment. Clinical interpretation is optimised by consideration of the strength of the MA-LIA result together with clinical and radiological features of IIM-ILD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Autoimmune disease | |
| 650 | 4 | |a Connective tissue disease | |
| 650 | 4 | |a Immunoblot | |
| 650 | 4 | |a Interstitial lung disease | |
| 650 | 4 | |a Myositis autoantibody | |
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| 650 | 7 | |a Autoantibodies |2 NLM | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a EXOSC9 protein, human |2 NLM | |
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| 700 | 1 | |a Troy, Lauren K |e verfasserin |4 aut | |
| 700 | 1 | |a Lau, Edmund M |e verfasserin |4 aut | |
| 700 | 1 | |a Jo, Helen E |e verfasserin |4 aut | |
| 700 | 1 | |a Teoh, Alan K Y |e verfasserin |4 aut | |
| 700 | 1 | |a Webster, Susanne |e verfasserin |4 aut | |
| 700 | 1 | |a Adelstein, Stephen |e verfasserin |4 aut | |
| 700 | 1 | |a Corte, Tamera J |e verfasserin |4 aut | |
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