1 / 22

clinical advances of anti-tif1γ autoantibody in a hungarian myositis cohort

clinical advances of anti-tif1γ autoantibody in a hungarian myositis cohort. Melinda Nagy-Vincze 1 , Zoltán Griger 1 , Levente Bodoki 1 , Zsuzsa Szankai 1 , Zoe E. Betteridge 2 , Katalin Dankó 1

dana-sutton
Download Presentation

clinical advances of anti-tif1γ autoantibody in a hungarian myositis cohort

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. clinicaladvances of anti-tif1γ autoantibodyin a hungarianmyositiscohort Melinda Nagy-Vincze 1, Zoltán Griger1, Levente Bodoki1, Zsuzsa Szankai1, Zoe E. Betteridge2, Katalin Dankó 1 1 University of Debrecen, Division of ClinicalImmunology, Dept. of InternalMedicine, Debrecen, Hungary2 University of Bath, Institute forRheumaticDiseases, Bath, UK

  2. idiopathicinflammatory myopathies • Polymyositis (PM) • Dermatomyositis (DM) • Juvene PM/DM • Inclusion body myositis (IBM) • Overlap myositis (OM) • Necrotizing autoimmun myopathy (NAM): • Cancerassociatedmyositis (CAM) • Statininduced myopathy • Infectioninduced myopathy

  3. idiopathic inflammatory myopathies –skinsymptoms Gottron’ssign and papule

  4. idiopathic inflammatory myopathies –skinsymptoms Heliotroprash Linearextensorerythema Periungualteleangiectasia

  5. idiopathic inflammatory myopathies –skinsymptoms Facialerythema V-sign Shawlsign Periorbitaloedema

  6. idiopathic inflammatory myopathies –skinsymptoms Calcinosiscutis Poikilodermaathrophicansvasculare Alopecia Livedoreticularis

  7. CAM (CancerAssociatedMyositis) • Frequency 7-66% • Relativeriskformalignancy • 3x in DM • 1,3x inPM-ben • Tumor types: ovarium, breast, lung, colon, endometrium, nasopharyngeal, lymphoma, prostata) • In time: • Beforemyositissymptoms (> 1 years) • Real paraneoplasia (- 1 – +5 years) • Aftermyositisdiagnosis (> 5 years) – role of immunosuppressivetherapy? R. Aggarwal, C.V. OddisParaneoplasticmyalgias and myositisRheumDisClin N Am 2011

  8. CAM - Etiology • Paraneoplasia • Cytotoxic/immunesuppressivetreatment (Methotrexat, cyclophosphamid) • Commontrigger (EBV?)

  9. Crossoverimmunityincam CellularImmuneresponse CD8+ T Ly CD4+ T Ly MSA B Ly MSA ? MSA Damage Crossreactions MSA Stuart M. LevineCurrOpinRheumatol 2006, 18:620-624

  10. Anti-TIF1γ • antigen: transcription intermedier factor1 gamma • 155/140kDa protein • 13–21% in adult and 23–29% in juvenile DM cases • severeskinsymptoms, • high tumor riskinadults

  11. Ourstudy • Autoantibodyanalysis from IIM patients’ serum (n=202) with ELISA and/or IPP • Frequency of anti-TIF1γpositivity • Frequency of TIF1γnegative CAM • Clinical and labfindingsassociated with anti-TIF1γpositivity .

  12. Parameters • Clinicalsymptoms • Proximalmuscleweakness • Distalmuscleweakness • Skinrash • Dysphagia • Raynaudphenomen • Arthralgia • ILD • Fever • Labresults: • CK and LDH levels • CRP • ESR • ANF positivity • Tumor markers

  13. TIF1γpositive patients (n=12) • CAM n=3 • Real paraneoplasiain DM (n=1) • Aftermyositisdiagnosisin DM (n=1) and in PM (n=1) • Subsets: • DM n=7 • JDM n=4 • PM n=1 • Gender: • Female 75% (n= 9) • Male 25 % (n=3)

  14. TIF1γpositivecampatient – realparaneoplasia • 34 years old, women • FirstsymptomsinApril 2007: • Skinrash • Muscleweakness • Dysphagia • Arthralgia • In July 2007 – ovarium tumor • Histology: adenocarcinoma with peritonealmetastasis • Operation and chemotherapy • Shediedin November 2007 due to heartfailure

  15. TIF1γnegativecam patients (n=51) • Subsets: • DM(n=33) • PM (n=18) • Gender: • Female 68% (n= 35) • Male 32 % (n=16) • In time: • realparaneoplasia (n=37) - 5 months • beforemyositis (n=2) - 73,5 months • Afterdiagnosis (n=12) – 181 months

  16. TIF1γnegativecam (n=51)

  17. Histology

  18. differencesinclinicalsymptoms (%)

  19. labfindings (%) • No differencesin tumor markers • No differencesinotherantibodies (ANF, APA)

  20. Conclusion • TIF1γpositivity is associated with several and severeskinrashes • Tumor specificitydidnotconfirmed • Autoantibodytestshelpusin the diagnosis • But tumor searching is necessary, speciallyin DM

  21. Thanks to mycollegues Prof. Dr. Dankó Katalin, Dr. Griger Zoltán, Dr. Bodoki Levente, Szankai Zsuzsa, ZoeE. Betteridge This researchwasorganizedwithin the following program: TÁMOP 4.2.4.A/2-11-1-2012-0001 National Excellence Program—local convergence program providingpersonnelsupportin the development and operationforstudentsandresearchers. The project wasfundedby the EU and the European SocialFund. The autoantibodyanalysiswassponsoredbythe ESF EuMyoNet Research NetworkingProgramme.

  22. Thanksfor the attention!

More Related