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The Relationship Between Anti-Cell Division Cycle and Apoptosis Regulator 1 Autoantibodies, Anti-Sp4 Autoantibodies,

Christopher A Mecoli1, David Fiorentino2, Jemima Albayda1

  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland.

ACR Open Rheumatology
|October 6, 2024
PubMed
Abstract

Insights

This study found that anti-Sp4 and anti-cell division cycle and apoptosis regulator 1 (anti-CCAR1) autoantibodies are negatively associated with cancer-associated myositis (CAM) in dermatomyositis (DM) patients. Patients negative for both antibodies may require increased cancer surveillance.

Area of Science:

  • Autoimmunity research
  • Dermatomyositis (DM) and cancer associations
  • Serological biomarkers in autoimmune diseases

Background:

  • Anti-transcription intermediary factor 1γ (anti-TIF1γ) autoantibodies are associated with cancer-associated myositis (CAM) in dermatomyositis (DM).
  • The roles of anti-cell division cycle and apoptosis regulator 1 (anti-CCAR1) and anti-Sp4 autoantibodies in DM and their association with CAM require further elucidation.

Purpose of the Study:

  • To determine the frequency and co-occurrence of anti-CCAR1 and anti-Sp4 autoantibodies in adult DM patients.
  • To investigate the association of these autoantibodies with cancer in two independent DM cohorts.

Main Methods:

  • Enzyme-linked immunosorbent assay (ELISA) was used to measure anti-CCAR1 and anti-Sp4 autoantibodies in anti-TIF1γ-positive DM patients from Johns Hopkins and Stanford cohorts.
  • Statistical analysis, including odds ratios (OR) and 95% confidence intervals (CI), was performed to assess the association between antibody status and cancer-associated myositis (CAM).

Main Results:

  • In both cohorts, approximately one-third of anti-TIF1γ-positive DM patients were positive for anti-Sp4, one-third for anti-CCAR1, 20% for both, and half were negative for both.
  • Patients lacking both anti-Sp4 and anti-CCAR1 antibodies showed a strong association with CAM (ORs ranging from 4.5 to 12.9).
  • Conversely, patients positive for anti-Sp4 or anti-CCAR1 demonstrated a strong negative association with CAM (ORs ranging from 0.07 to 0.22).

Conclusions:

  • Anti-Sp4 and anti-CCAR1 autoantibodies are significantly negatively associated with cancer-associated myositis (CAM) in anti-TIF1γ-positive DM patients.
  • While cancer can occur in patients positive for these antibodies, the subgroup negative for both anti-Sp4 and anti-CCAR1 (approximately 50% of anti-TIF1γ-positive DM patients) warrants closer cancer surveillance.

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