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You are here: Home / Articles / Autoantibodies in Autoimmune Myopathy

Autoantibodies in Autoimmune Myopathy

September 18, 2017 • By Ruth Jessen Hickman, MD

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However, some researchers argue that the distinction between MSAs and MAAs may not be a valuable one, because some patients positive for MSAs never actually develop myositis. Some have even suggested replacing these terms with more general terms, such as CTD-myositis overlap or interstitial lung disease (ILD) autoantibodies, to emphasize the fact that these autoantibodies can present in a number of different clinical settings.3

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Myositis-correlated autoantibodies (including MSAs and MAAs) are detected in about 80% of myositis patients.7 This number, however, may not reflect the true percentage of these patients with positive autoantibodies, because new autoantibodies continue to be discovered. More than 20 such MSAs and MAAs have been described.3

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The pathophysiology of these autoantibodies is still uncertain, because scientists do not understand the full etiology of these conditions.8 These autoantibodies target ubiquitous intracellular antigens, and it is unclear why these autoantibodies would be associated with predominantly muscular symptoms. It is not known whether these autoantibodies play a role in the etiology of these diseases or whether they may simply serve as helpful disease markers.5

Rohit Aggarwal, MD, MS, is the medical director of the Arthritis and Autoimmunity Center, associate professor of medicine and co-director of the UPMC Myositis Center at the University of Pittsburgh. He explains, “These autoantibodies may be a silent bystander in some cases, but in some cases, evidence suggests these autoantibodies may be playing an active role in the pathogenesis of myositis. For example anti-synthetase antibodies, especially anti-Jo-1 antibodies, have been linked with pathogenesis.”

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MSAs’ Clinical Impact

The following is a non-comprehensive sampling of relevant information about MSAs in IIM.

Anti-Aminoacyl-tRNA Synthetase Autoantibodies (Anti-ARS Antibodies)
This group of antibodies is the most common group as a whole. It includes the most commonly found MSA, the anti-Jo autoantibody, which targets a specific aminoacyl-tRNA synthetase used during protein synthesis. To date, eight such autoantibodies have been described, and more may be found in the future targeting the other known versions of the aminoacyl-tRNA synthetase enzyme.2,3

Patients with anti-ARS antibodies may have anti-synthetase syndrome, characterized by muscle symptoms, interstitial lung disease, joint involvement, “mechanic’s hand,” fever and Raynaud symptoms.

Dr. Gunawardena

Dr. Gunawardena

Dr. Gunawardena explains, “Some patients can present or develop all manifestations. Some patients have just a few (e.g., in lung-dominant anti-synthetase syndrome) and never develop myositis. Regardless of the anti-synthetase autoantibody subtype, if we see a patient with CTD-myositis overlap and they test positive for anti-synthetase, this indicates a higher risk of interstitial lung disease.”

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Filed Under: Conditions, Systemic Inflammatory Syndromes Tagged With: autoantibodies, Autoimmune disease, Classification, connective tissue disease, dermatomyositis, Diagnosis, idiopathic inflammatory myopathies, myositis, patient care, polymyositis, prognosis, Research, rheumatologist, rheumatology, Systemic sclerosis, Test, TreatmentIssue: September 2017

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About Ruth Jessen Hickman, MD

Ruth Jessen Hickman, MD, was born and raised in eastern Kentucky, where she first cultivated her love of literature, writing and personal narratives. She attended Kenyon college, where she received a Bachelor of Arts in philosophy, summa cum laude. She worked with individuals with psychiatric conditions and later in a neuroscience lab at the University of Illinois, Chicago, before graduating from Indiana University Medical School in 2011. Instead of pursuing clinical medicine, Ruth opted to build on her strength of clearly explaining medical topics though a career as a freelance medical writer, writing both for lay people and for health professionals. She writes across the biomedical sciences, but holds strong interests in rheumatology, neurology, autoimmune diseases, genetics, and the intersection of broader social, cultural and emotional contexts with biomedical topics. Ruth now lives in Bloomington, Ind., with her husband, son and cat. She can be contacted via her website at ruthjessenhickman.com.

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