Klinik Araştırma
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İnflamatuvar Miyopatilerde Miyozit Spesifik Antikorlar ve Klinik Kullanımı: Tek Merkez Deneyimi

Yıl 2025, Cilt: 47 Sayı: 6, 997 - 1002, 26.09.2025
https://doi.org/10.20515/otd.1715773

Öz

Miyozit spesifik antikorlar (MSA), inflamatuvar miyozitleri sınıflandırmada, klinik seyir ve prognozu öngörmede son yıllarda artan sıklıkla kullanılmaktadır. Bu çalışmada merkezimizde takipli inflamatuvar miyopatili hastalar içerisinde miyozit spesifik antikoru çalışılmış hastaların demografik özellikleri, tanıları, klinik bulguları, laboratuvar verileri, antikor profilleri, enfeksiyöz komplikasyon ve malignite gelişimi ve mortalite verileri analiz edildi. Çalışmaya toplam 33 hasta dahil edildi (29 kadın, 4 erkek). Medyan yaş 52 yıl (15-72) ve medyan takip süresi 27 ay (2-250) olarak hesaplandı. Hastaların 15 (%45.4)’i dermatomiyozit tanılı idi. Hastaların 26’sında MSA pozitif saptandı. En sık pozitif saptanan antikorlar Jo-1 (%26,9) ve TIF-1 gamma (%23,1) idi. MSA pozitif inflamatuvar myopatili hastalarda konstitüsyonel semptomlar daha sık görülmekteydi (p:0,011). MSA alt gruplarına (Jo-1 ve diğerleri/ TIF-1 gamma ve diğerleri/ MDA-5 ve diğerleri) göre klinik bulgular değerlendirildiğinde; pulmoner tutulum ile Jo-1 pozitifliği (p<0,001) ve MDA-5 pozitifliği ile kalsinozis (p:0,018) arasında istatistiksel olarak anlamlı bir ilişki bulundu. Toplam 13 hastada infeksiyöz komplikasyonlar ve 3 hastada malignite gelişmişti (serviks, over ve kolorektal karsinom). Çalışmamızda MSA alt gruplarının sıklığı literatür ile benzerlik taşısa da genelleme yapabilmek için geniş hasta popülasyonunda yapılacak çalışmalara ihtiyaç vardır.

Kaynakça

  • 1. Espinosa-Ortega F, Lodin K, Dastmalchi M, et al. Autoantibodies and damage in patients with idiopathic inflammatory myopathies: A longitudinal multicenter study from the MYONET international network. Semin Arthritis Rheum. 2024;68:152529.
  • 2. Allameen NA, Ramos-Lisbona AI, Wedderburn LR, Lundberg IE, Isenberg DA. An update on autoantibodies in the idiopathic inflammatory myopathies. Nat Rev Rheumatol. 2025;21(1):46-62.
  • 3. Schumacher F, Zimmermann M, Kanbach M, et al. Clinical relevance of positively determined myositis antibodies in rheumatology: a retrospective monocentric analysis. Arthritis Res Ther. 2024;26(1):132. Published 2024 Jul 16.
  • 4. Lundberg IE, Tjärnlund A, Bottai M, et al. 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups [published correction appears in Ann Rheum Dis. 2018 Sep;77(9):e64. doi: 10.1136/annrheumdis-2017-211468corr1.]. Ann Rheum Dis. 2017;76(12):1955-1964.
  • 5. Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292(7):344-347.
  • 6. Mammen AL, Allenbach Y, Stenzel W, Benveniste O; ENMC 239th Workshop Study Group. 239th ENMC International Workshop: Classification of dermatomyositis, Amsterdam, the Netherlands, 14-16 December 2018. Neuromuscul Disord. 2020;30(1):70-92.
  • 7. Aggarwal R, Cassidy E, Fertig N, et al. Patients with Non-Jo-1 Anti-tRNA-synthetase Autoantibodies have Worse Survival than Jo-1 Positive Patients. Ann Rheum Dis, 2014;73(1):227–232.
  • 8. Hengstman GJD, Egberts WTMV, Seelig HP, et al. Clinical Characteristics of Patients with Myositis and Autoantibodies to Different Fragments of the Mi-2 beta Antigen. Ann Rheum Dis, 2006;65(2):242–245.
  • 9. Wang L, Liu L, Hao H, et al. Myopathy with Anti-signal Recognition Particle Antibodies: Clinical and Histopathological Features in Chinese Patients. Neuromuscul Disord, 2014;24(4):335–341.
  • 10. Fiorentino DF, Chung LS, Christopher-Stine L, et al. Most Patients with Cancer-associated Dermatomyositis have Antibodies to Nuclear Matrix Protein NXP-2 or Transcription Intermediary Factor 1γ. Arthritis Rheum, 2013;65(11):2954–2962.
  • 11. Bailey EE, Fiorentino DF. Amyopathic Dermatomyositis: Definitions, Diagnosis, and Management. Curr Rheumatol Rep, 2014;16(12):465.
  • 12. Guimarães F, Yildirim R, Isenberg DA. Long-term survival of patients with idiopathic inflammatory myopathies: anatomy of a single-centre cohort. Clin Exp Rheumatol. 2023;41(2):322-329.

Myositis-Specific Autoantibodies in Patients with Inflammatory Myopathies and Clinical Practice: a Single Centre Experience

Yıl 2025, Cilt: 47 Sayı: 6, 997 - 1002, 26.09.2025
https://doi.org/10.20515/otd.1715773

Öz

Myositis-specific autoantibodies (MSAs) have been increasingly utilized in recent years for the classification of inflammatory myopathies, and for predicting clinical course and prognosis. In this study, patients with idiopathic inflammatory myopathy diagnosis whose MSAs were present included in this study. were screened randomly for the presence of MSAs within the past year. Demographic characteristics, myositis type, clinical manifestations, laboratory findings, autoantibody profiles, infectious complications, malignancy development, and mortality data were analyzed. A total of 33 patients were included in the study (29 female, 4 male). The median age was 52 years (range: 15–72), and the median follow-up duration was 27 months (range: 2–250). Dermatomyositis was the most common myositis type (45.4%). 26 patients had at least one positive MSA. The most frequently detected antibodies were anti-Jo-1 (26.9%) and anti-TIF-1γ (23.1%). Constitutional symptoms were more frequently observed in the MSA-positive group (p = 0.011). When clinical features were evaluated according to MSA subgroups (Jo-1 vs. others; TIF-1γ vs. others; MDA-5 vs. others), a statistically significant association was found for Jo-1 positivity and pulmonary involvement (p < 0.001), and between MDA-5 positivity and calcinosis (p = 0.018). Infectious complications were observed in 13 patients, and malignancy developed in 3 patients (cervical, ovarian, and colorectal carcinoma). Although the frequency of MSA subgroups in our cohort was consistent with the literature, further studies with larger patient populations are needed to evaluate the relationship

Kaynakça

  • 1. Espinosa-Ortega F, Lodin K, Dastmalchi M, et al. Autoantibodies and damage in patients with idiopathic inflammatory myopathies: A longitudinal multicenter study from the MYONET international network. Semin Arthritis Rheum. 2024;68:152529.
  • 2. Allameen NA, Ramos-Lisbona AI, Wedderburn LR, Lundberg IE, Isenberg DA. An update on autoantibodies in the idiopathic inflammatory myopathies. Nat Rev Rheumatol. 2025;21(1):46-62.
  • 3. Schumacher F, Zimmermann M, Kanbach M, et al. Clinical relevance of positively determined myositis antibodies in rheumatology: a retrospective monocentric analysis. Arthritis Res Ther. 2024;26(1):132. Published 2024 Jul 16.
  • 4. Lundberg IE, Tjärnlund A, Bottai M, et al. 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups [published correction appears in Ann Rheum Dis. 2018 Sep;77(9):e64. doi: 10.1136/annrheumdis-2017-211468corr1.]. Ann Rheum Dis. 2017;76(12):1955-1964.
  • 5. Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292(7):344-347.
  • 6. Mammen AL, Allenbach Y, Stenzel W, Benveniste O; ENMC 239th Workshop Study Group. 239th ENMC International Workshop: Classification of dermatomyositis, Amsterdam, the Netherlands, 14-16 December 2018. Neuromuscul Disord. 2020;30(1):70-92.
  • 7. Aggarwal R, Cassidy E, Fertig N, et al. Patients with Non-Jo-1 Anti-tRNA-synthetase Autoantibodies have Worse Survival than Jo-1 Positive Patients. Ann Rheum Dis, 2014;73(1):227–232.
  • 8. Hengstman GJD, Egberts WTMV, Seelig HP, et al. Clinical Characteristics of Patients with Myositis and Autoantibodies to Different Fragments of the Mi-2 beta Antigen. Ann Rheum Dis, 2006;65(2):242–245.
  • 9. Wang L, Liu L, Hao H, et al. Myopathy with Anti-signal Recognition Particle Antibodies: Clinical and Histopathological Features in Chinese Patients. Neuromuscul Disord, 2014;24(4):335–341.
  • 10. Fiorentino DF, Chung LS, Christopher-Stine L, et al. Most Patients with Cancer-associated Dermatomyositis have Antibodies to Nuclear Matrix Protein NXP-2 or Transcription Intermediary Factor 1γ. Arthritis Rheum, 2013;65(11):2954–2962.
  • 11. Bailey EE, Fiorentino DF. Amyopathic Dermatomyositis: Definitions, Diagnosis, and Management. Curr Rheumatol Rep, 2014;16(12):465.
  • 12. Guimarães F, Yildirim R, Isenberg DA. Long-term survival of patients with idiopathic inflammatory myopathies: anatomy of a single-centre cohort. Clin Exp Rheumatol. 2023;41(2):322-329.
Toplam 12 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Romatoloji ve Artrit
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Mesut Ajder 0009-0004-2403-4675

Reşit Yıldırım 0000-0003-4040-0212

Burcu Ceren Uludoğan 0000-0001-7838-7629

Nilgün Kaşifoğlu 0000-0002-1470-2308

Nazife Şule Yaşar Bilge 0000-0002-0783-1072

Timuçin Kaşifoğlu 0000-0003-2544-8648

Yayımlanma Tarihi 26 Eylül 2025
Gönderilme Tarihi 9 Haziran 2025
Kabul Tarihi 4 Eylül 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 6

Kaynak Göster

Vancouver Ajder M, Yıldırım R, Uludoğan BC, Kaşifoğlu N, Yaşar Bilge NŞ, Kaşifoğlu T. İnflamatuvar Miyopatilerde Miyozit Spesifik Antikorlar ve Klinik Kullanımı: Tek Merkez Deneyimi. Osmangazi Tıp Dergisi. 2025;47(6):997-1002.


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