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Calcinosis and malignancy are rare in Chinese adult patients with myositis and nuclear matrix protein 2 antibodies identified by an unlabeled immunoprecipitation assay.

Abstract
Autoantibodies in patients with myositis may associate with specific clinical manifestations. This study aimed to identify a subset of patients with myositis carrying antinuclear matrix protein 2 (anti-NXP-2) antibodies using an unlabeled immunoprecipitation (IP) assay, and clarify the features of these patients in a Chinese cohort. We developed novel methods for unlabeled protein IP and immunoblotting of Myc-tagged truncated NXP-2 fragments for anti-NXP-2 detection. The sera of 120 Chinese adult patients with myositis were screened for anti-NXP-2 by IP and immunoblot. Anti-NXP-2 antibodies were detected in 10 of the 120 patients (8.3%) using the established unlabeled protein IP and immunoblotting, with 70% (7/10) exhibiting either heliotrope rash or Gottron's papules. All 10 anti-NXP-2-positive patients exhibited myopathy and 60% complained of dysphagia. Severe diffuse calcinosis (10%) and nasopharyngeal carcinoma (10%) were each only present in single anti-NXP-2-positive patients with myositis. Antibodies against Ro-52 were found in four living but not in three deceased anti-NXP-2-positive patients. A comprehensive review of 13 anti-NXP-2 studies demonstrated markedly lower anti-NXP-2 prevalence among adult patients with myositis and lower association of anti-NXP-2 with calcinosis in Japan, China, and Hungary than in the USA and Italy. Anti-NXP-2 antibody association with internal malignancy in adult patients varied from 0 to 50% across different studies. A novel IP assay was developed to detect patients with myositis expressing anti-NXP-2. Calcinosis and malignancy are rare in Chinese adult patients with myositis positive for anti-NXP-2. Literature review indicated highest anti-NXP-2 prevalence and association of anti-NXP-2 with calcinosis in US and Italian myositis cohorts.
AuthorsLi Wang, Li Huang, Yang Yang, Huan Chen, Yanjuan Liu, Ke Liu, Meidong Liu, Yizhi Xiao, Hui Luo, Xiaoxia Zuo, Yisha Li, Xianzhong Xiao, Huali Zhang
JournalClinical rheumatology (Clin Rheumatol) Vol. 37 Issue 10 Pg. 2731-2739 (Oct 2018) ISSN: 1434-9949 [Electronic] Germany
PMID30039266 (Publication Type: Journal Article, Review)
Chemical References
  • Autoantibodies
  • DNA-Binding Proteins
  • Transcription Factors
  • nuclear matrix protein 2
Topics
  • Adult
  • Autoantibodies (analysis)
  • Calcinosis (epidemiology, immunology)
  • China (epidemiology)
  • DNA-Binding Proteins (immunology)
  • Female
  • Humans
  • Hungary (epidemiology)
  • Immunoprecipitation (methods)
  • Italy (epidemiology)
  • Japan (epidemiology)
  • Male
  • Middle Aged
  • Myositis (complications, immunology)
  • Neoplasms (epidemiology, immunology)
  • Prevalence
  • Transcription Factors (immunology)
  • United States (epidemiology)

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