Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Anti-p155/140 (anti-TIF1) Autoantibodies in Patients with Cancer Associated Myositis Detected in a Single Centre
Vencovsky1, Jiri, Mann2, Herman, Putova1, Ivana, Betteridge3, Zoe, Gunawardena3, Harsha, McHugh3, Neil J.
Institute of Rheumatology and Department of Rheumatology of the 1st Faculty of Medicine. Charles University, Prague 2, Czech Republic
Institute of Rheumatology, Prague 2, Czech Republic
Royal National Hospital, Bath, United Kingdom
Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases of striated muscles. About 1020% cases are associated with various forms of cancer (CAM). No specific signs and symptoms can distinguish between patients with CAM from patients without malignancy. Recently described autoantibodies to p155/140 antigen (Anti-TIF1g= transcriptional intermediary factor 1-g) have been associated with an increased frequency of cancer in patients with DM. The aim of this study was to determine the frequency of anti-p155/140 antibodies in the cohort of patients with PM/DM and relate the presence of these antibodies to an occurrence of cancer.
Patients with definite or probable diagnosis of PM/DM (n=153) from a single centre were investigated for the presence of a cancer. CAM was defined as any cancer occuring within the timeframe of 3 years of the onset of myositis. Sera were mixed with protein-A-sepharose beads and immunoprecipitated with [35S]-methionine-labelled K562 cell extract. Proteins were fractionated by SDS-PAGE and analysed by autoradiography.
Seventeen patients (11%) were diagnosed with CAM. Sixteen patients (10.5%) had anti-p155/140 antibodies. In patients with CAM, 7 (41%) had anti-p155/140, whereas in non-cancer patients the frequency of anti-p155/140 was 6.6% (p<0.0001; OR=9.9). Testing for anti-155/140 antibodies was 41% sensitive for the detection of CAM with a 44% PPV; and 93% specific for non-CAM with high NPV 93%. Four out of 17 CAM patients had polymyositis; however, none of these had anti-p155/140 antibodies. Only 1 patient from anti-p155/140+ group had PM and this patient was non-CAM. There was no apparent difference in the type of cancer between anti-p155/140 positive and negative patients, although data are somewhat suggestive to a more disseminated process in positives.
Possession of anti-p155/140 (anti-TIF1g) antibodies represented a significant risk for cancer associated dermatomyositis. This fact may provide a strong argument for thorough search of malignancy in patients diagnosed with DM and anti-p155/140 antibodies. Routinely available testing is needed since it will have significant clinical implications.
Supported by MSM 0021620812 from Ministry of Education, Youth and Sports in the Czech Republic and by European Union 6.FP integrated project AutoCure LSHB CT-2006-018661.
To cite this abstract, please use the following information:
Vencovsky, Jiri, Mann, Herman, Putova, Ivana, Betteridge, Zoe, Gunawardena, Harsha, McHugh, Neil J.; Anti-p155/140 (anti-TIF1) Autoantibodies in Patients with Cancer Associated Myositis Detected in a Single Centre [abstract]. Arthritis Rheum 2009;60 Suppl 10 :809