Medicina clinica · 2026
The distribution and clinical significance of anti-nuclear antibodies in patients with idiopathic inflammatory myopathy in Southwest China.
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Guo Yixue, Liu Hongjiang, Zhang Keyi, Meng Liye, Niu Qian, Zhang Junlong, Xie Qibing, Huang Zhuochun
Аннотация
BACKGROUND: Idiopathic inflammatory myopathies (IIMs) are a group of autoimmune diseases characterized by skeletal muscle involvement. The association of anti-nuclear antibody (ANA) testing with clinical features in IIM patients has not been fully elucidated.
METHODS: We retrospectively included patients who were diagnosed with IIM between January 2012 and February 2023, then systematically tested ANA titers and analyzed the ANA patterns of IIM patients by indirect immunofluorescence assay (IFA). Demographic, clinical and relevant laboratory data were recorded and further analyzed in 673 ANA-positive IIM patients.
RESULTS: Of the 673 IIM patients, 487 (72.4%) were female. Nuclear speckled (58.2%) and cytoplasmic speckled (21.5%) were the most common observed ANA patterns in our cohort. The high ANA titer group had lower complement (C3: P=0.001; C4: P<0.0001), white blood cell counts (P=0.023) and elevated positive rates of extractable nuclear antigen (ENA) antibodies (all P<0.05) compared to the low ANA titer group. In addition, the proportion of nuclear speckled patterns was higher in the low ANA titer group (P<0.0001), while the high ANA titer group displayed more cytoplasmic speckled patterns (P=0.001). There were statistically significant differences in ANA titers (P=0.015) and patterns (P=0.023) among different myositis subtypes. Meanwhile, it was notable that patients with cytoplasmic speckled patterns had the highest interstitial lung disease (ILD) prevalence.
CONCLUSIONS: ANA titers and patterns may predict prognosis in IIM patients.
METHODS: We retrospectively included patients who were diagnosed with IIM between January 2012 and February 2023, then systematically tested ANA titers and analyzed the ANA patterns of IIM patients by indirect immunofluorescence assay (IFA). Demographic, clinical and relevant laboratory data were recorded and further analyzed in 673 ANA-positive IIM patients.
RESULTS: Of the 673 IIM patients, 487 (72.4%) were female. Nuclear speckled (58.2%) and cytoplasmic speckled (21.5%) were the most common observed ANA patterns in our cohort. The high ANA titer group had lower complement (C3: P=0.001; C4: P<0.0001), white blood cell counts (P=0.023) and elevated positive rates of extractable nuclear antigen (ENA) antibodies (all P<0.05) compared to the low ANA titer group. In addition, the proportion of nuclear speckled patterns was higher in the low ANA titer group (P<0.0001), while the high ANA titer group displayed more cytoplasmic speckled patterns (P=0.001). There were statistically significant differences in ANA titers (P=0.015) and patterns (P=0.023) among different myositis subtypes. Meanwhile, it was notable that patients with cytoplasmic speckled patterns had the highest interstitial lung disease (ILD) prevalence.
CONCLUSIONS: ANA titers and patterns may predict prognosis in IIM patients.