TY - JOUR
T1 - Myositis-specific autoantibodies, a cornerstone in immune-mediated necrotizing myopathy
AU - Anquetil, Céline
AU - Boyer, Olivier
AU - Wesner, Nadège
AU - Benveniste, Olivier
AU - Allenbach, Yves
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Over the past few years, myositis-specific autoantibodies played an increasing role in the inflammatory idiopathic myositis definition. They became the critical immunological marker for immune-mediated necrotizing myopathy diagnosis (IMNM) since the paradigm switch from histological to serological criteria. This review is focused on the key role of the anti-signal recognition particle (anti-SRP) and the anti-3-Hydroxy-3-MethylGlutaryl-Coenzyme A Reductase (anti-HMGCR) antibodies in immune-mediated necrotizing myopathy. Anti-SRP and anti-HMGCR antibodies are robust diagnostic tools in case of both the classical subacute form and the slowly progressive form of IMNM that may mimic muscular dystrophy. Anti-SRP and anti-HMGCR patients share clinical, biological and histological features with some antibody-associated specificity. Anti-SRP patients harbour more severe muscle weakness and atrophy with severe muscle damage on magnetic resonance imaging study. Approximately 10–20% of anti-SRP patients develop extramuscular symptoms, especially lung interstitial disease. Conversely, anti-HMGCR patients are often associated with statin exposure. In both cases, patients have a poor outcome with frequent relapse and the use of combined immunotherapy. Of note, various data suggest a direct pathogenic role of these antibodies reinforcing the interest in targeted therapeutic strategy.
AB - Over the past few years, myositis-specific autoantibodies played an increasing role in the inflammatory idiopathic myositis definition. They became the critical immunological marker for immune-mediated necrotizing myopathy diagnosis (IMNM) since the paradigm switch from histological to serological criteria. This review is focused on the key role of the anti-signal recognition particle (anti-SRP) and the anti-3-Hydroxy-3-MethylGlutaryl-Coenzyme A Reductase (anti-HMGCR) antibodies in immune-mediated necrotizing myopathy. Anti-SRP and anti-HMGCR antibodies are robust diagnostic tools in case of both the classical subacute form and the slowly progressive form of IMNM that may mimic muscular dystrophy. Anti-SRP and anti-HMGCR patients share clinical, biological and histological features with some antibody-associated specificity. Anti-SRP patients harbour more severe muscle weakness and atrophy with severe muscle damage on magnetic resonance imaging study. Approximately 10–20% of anti-SRP patients develop extramuscular symptoms, especially lung interstitial disease. Conversely, anti-HMGCR patients are often associated with statin exposure. In both cases, patients have a poor outcome with frequent relapse and the use of combined immunotherapy. Of note, various data suggest a direct pathogenic role of these antibodies reinforcing the interest in targeted therapeutic strategy.
KW - 3-hydroxy-3-methylglutaryl-coenzyme a reductase
KW - Autoantibodies
KW - Immune-mediated necrotizing myopathy
KW - Signal recognition particle
UR - http://www.scopus.com/inward/record.url?scp=85060548925&partnerID=8YFLogxK
U2 - 10.1016/j.autrev.2018.09.008
DO - 10.1016/j.autrev.2018.09.008
M3 - Review article
C2 - 30639649
AN - SCOPUS:85060548925
SN - 1568-9972
VL - 18
SP - 223
EP - 230
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
IS - 3
ER -