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Rheumatology (Oxford). 2016 Jun;55(6):991-9. doi: 10.1093/rheumatology/kev444. Epub 2016 Feb 16.

Autoantibody levels in myositis patients correlate with clinical response during B cell depletion with rituximab.

Author information

1
Division of Rheumatology and Clinical Immunology, University of Pittsburgh Department of Medicine, Pittsburgh, PA, docrota@gmail.com.
2
Division of Rheumatology and Clinical Immunology, University of Pittsburgh Department of Medicine, Pittsburgh, PA.
3
Department of Pediatrics, Duke University School of Medicine, Durham, NC and.
4
Division of Rheumatology and Immunology, University of Miami Department of Medicine, Miami, FL, USA.

Abstract

OBJECTIVES:

To determine the longitudinal trends in serum levels of four myositis-associated autoantibodies: anti-Jo-1, -transcription intermediary factor 1 γ (TIF1-γ), -signal recognition particle (SRP) and -Mi-2, after B cell depletion with rituximab, and to determine the longitudinal association of these autoantibody levels with disease activity as measured by myositis core-set measures (CSMs).

METHODS:

Treatment-resistant adult and pediatric myositis subjects (n = 200) received rituximab in the 44-week Rituximab in Myositis Trial. CSMs [muscle enzymes, manual muscle testing (MMT), physician and patient global disease activity, HAQ, and extramuscular disease activity] were evaluated monthly and anti-Jo-1 (n = 28), -TIF1-γ (n = 23), -SRP (n = 25) and -Mi-2 (n = 26) serum levels were measured using validated quantitative ELISAs. Temporal trends and the longitudinal relationship between myositis-associated autoantibodies levels and CSM were estimated using linear mixed models.

RESULTS:

Following rituximab, anti-Jo-1 levels decreased over time (P < 0.001) and strongly correlated with all CSMs (P < 0.008). Anti-TIF1-γ levels also decreased over time (P < 0.001) and were only associated with HAQ, MMT and physician and patient global disease activity. Anti-SRP levels did not change significantly over time, but were significantly associated with serum muscle enzymes. Anti-Mi-2 levels significantly decreased over time and were associated with muscle enzymes, MMT and the physician global score.

CONCLUSION:

Anti-Jo-1, anti-TIF1-γ and anti-Mi-2 levels in myositis subjects decreased after B cell depletion and were correlated with changes in disease activity, whereas anti-SRP levels were only associated with longitudinal muscle enzyme levels. The strong association of anti-Jo-1 levels with clinical outcomes suggests that anti-Jo-1 autoantibodies may be a good biomarker for disease activity.

KEYWORDS:

and anti-Mi-2 autoantibodies; anti-Jo-1; anti-SRP; anti-TIF1-γ; autoantibody levels; disease activity; myositis; rituximab

PMID:
26888854
DOI:
10.1093/rheumatology/kev444
[Indexed for MEDLINE]

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