Novel serology testing for sporadic inclusion body myositis: disease-specificity and diagnostic utility

The purpose of this article is to discuss recent advances in serological testing for sporadic inclusion body myositis (sIBM) and to provide a review of their diagnostic utility and disease-specificity of auto-antibodies in sIBM.

The identification, prevalence and diagnostic utility of a new auto-antibody targeting cytosolic 5'-nucleotidase 1A (cN-1A) in the serum of sIBM patients have recently been published. These studies have shown that anti-cN-1A auto-antibodies have diagnostic utility for differentiating sIBM from other forms of myositis and from other neuromuscular diseases. Anti-cN-1A-positive patient sera are directed to multiple epitopes of cN-1A and contain, in addition to IgG, IgA and IgM, anti-cN-1A auto-antibodies. Recent studies have also shown a relatively high prevalence of these auto-antibodies in sera form Sjögren's syndrome and systemic lupus erythematosus patients.

The recent discovery of auto-antibodies to cN-1A provides a serological tool to aid the differentiation between inflammatory myopathies and supports the idea that apart from degeneration, an adaptive immune response may also play a role in sIBM pathophysiology. Future research will need to focus on standardization of methods to detect these auto-antibodies in order to further explore their specificity and diagnostic utility for sIBM.