Autoantibodies to Mi-2 alpha and Mi-2 beta in patients with idiopathic inflammatory myopathy

Rheumatology (Oxford). 2019 Sep 1;58(9):1655-1661. doi: 10.1093/rheumatology/kez092.

Abstract

Objectives: The objective of this study was to compare the results obtained from different assays for the detection of anti-Mi-2 antibodies, which are important markers in the diagnosis of DM.

Methods: The study included 82 patients (68 females/14 males), most of whom had DM (n = 57), followed by PM (n = 16) and juvenile DM (n = 9). All samples were tested using a novel particle-based multi-analyte technology (PMAT) (Inova Diagnostics, research use only) in parallel with a line immunoassay (LIA: Euroimmun). To assess clinical specificity for the PMAT assay, a total of 775 disease and healthy controls were tested.

Results: 29 samples were positive by at least one test for anti-Mi-2 antibodies. Of those, 24 were Mi-2β LIA+, five were Mi-2α LIA+ and 23 Mi-2 PMAT+. The comparison shows varying agreement between the different methods (kappa 0.27-0.77). When LIA results were used as reference for receiver operating characteristics analysis, high area under the curve values were found for both PMAT vs LIA Mi-2α and LIA Mi-2β. When analysing the results in the context of the myositis phenotype, PMAT associated closest with the DM phenotype. In the control group, 3/775 controls (all low levels) were anti-Mi-2+ resulting in a sensitivity and specificity of 28.1% and 99.6%, respectively.

Conclusion: Overall, good agreement was found between LIA and PMAT for anti-Mi-2 antibodies, which is important for the standardization of autoantibodies. Anti-Mi-2β antibodies measured by PMAT tend be more highly associated with the clinical phenotype of DM.

Keywords: DM; anti-Mi-2 antibodies; autoantibodies; immunoassay; myositis.

Publication types

  • Review

MeSH terms

  • Autoantibodies / blood*
  • Biomarkers / blood
  • Case-Control Studies
  • Dermatomyositis / diagnosis
  • Dermatomyositis / immunology
  • Female
  • Humans
  • Immunoassay / methods
  • Male
  • Mi-2 Nucleosome Remodeling and Deacetylase Complex / immunology*
  • Myositis / diagnosis*
  • Myositis / immunology
  • Polymyositis / diagnosis
  • Polymyositis / immunology
  • ROC Curve
  • Reproducibility of Results

Substances

  • Autoantibodies
  • Biomarkers
  • CHD4 protein, human
  • Mi-2 antibodies
  • Mi-2 Nucleosome Remodeling and Deacetylase Complex