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Dermatomyositis autoantibodies: how can we maximize utility?
Luqman Mushila Hodgkinson1, Tiffany Tingshuen Wu1, David Franklin Fiorentino1
1Department of Dermatology, Stanford University School of Medicine, Redwood City, CA, USA.
Annals of Translational Medicine
|April 12, 2021
Summary
Myositis-specific autoantibodies (MSAs) in dermatomyositis (DM) correlate with unique clinical and pathological phenotypes. Understanding these associations is crucial for accurate diagnosis, risk assessment, and personalized treatment strategies.
Area of Science:
- Immunology
- Rheumatology
- Dermatology
Background:
- Significant advances in characterizing myositis-specific autoantibodies (MSAs) over 15 years.
- Unique clinical and pathological phenotypes are associated with each MSA in dermatomyositis (DM).
- Heterogeneity within antibody classes and overlap across groups exist.
Purpose of the Study:
- To review key considerations for interpreting clinical and pathological associations with MSAs in DM.
- To identify critical knowledge and practice gaps for maximizing clinical utility.
- To enhance understanding of MSAs for improved diagnosis, treatment, and pathogenesis insights.
Main Methods:
- Literature review of studies on MSAs and dermatomyositis phenotypes.
- Analysis of clinical and pathological data associated with different MSAs.
- Evaluation of current diagnostic assay limitations and standardization needs.
Main Results:
- Specific MSAs are linked to distinct phenotypes, including risks for interstitial lung disease (ILD) and malignancy.
- Assays for MSAs have varying sensitivity and specificity, impacting diagnostic accuracy.
- MSAs aid in assessing patient risk and guiding treatment expectations.
Conclusions:
- Deeper understanding and standardization of MSA assays are critical for optimizing DM diagnosis and treatment.
- Further research is needed to fully leverage MSAs for actionable risk assessment and understanding disease pathogenesis.
- International standardization and larger studies will likely integrate more MSA tests into diagnostic schemata.
