Brief Report: Anti–Calponin 3 Autoantibodies: A Newly Identified Specificity in Patients With Sjögren’s Syndrome
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Abstract:
Autoantibodies are clinically useful for phenotyping patients across the spectrum of autoimmune rheumatic diseases. Using serum from a patient with Sjögren's syndrome (SS), we detected a new specificity by immunoblotting. This study was undertaken to identify this autoantibody and to evaluate its disease specificity.A prominent 40-kd band was detected when immunoblotting was performed using SS patient serum and lysate from rat dorsal root ganglia (DRGs). Using 2-dimensional gel electrophoresis and liquid chromatography tandem mass spectrometry peptide sequencing, the autoantigen was identified as calponin 3. Anti-calponin 3 antibodies were evaluated in sera from patients with primary SS (n = 209), patients with systemic lupus erythematosus (SLE; n = 138), patients with myositis (n = 138), patients with multiple sclerosis (MS; n = 44), and healthy controls (n = 46) by enzyme-linked immunosorbent assay. Expression of calponin 3 was assessed by immunohistochemistry.Calponin 3 was identified as a new autoantigen. Anti-calponin 3 antibodies were detected in 23 (11.0%) of the 209 SS patients, 12 (8.7%) of the 138 SLE patients, 7 (5.1%) of the 138 myositis patients, 3 (6.8%) of the 44 MS patients, and 1 (2.2%) of the 46 healthy controls. Among SS patients, the frequency of anti-calponin 3 antibodies was highest in those with neuropathies (7 [17.9%] of 39). In this subset, the frequency of anti-calponin 3 antibodies differed significantly from that in the control group (P = 0.02). Calponin 3 was expressed primarily in rat DRG perineuronal satellite cells but not neurons.Calponin 3 is a novel autoantigen. Antibodies against this protein are found in SS and associate with the subset of patients experiencing neuropathies. Intriguingly, we found that calponin 3 is expressed in DRG perineuronal satellite cells, suggesting that these may be a target in SS.Keywords:
Calponin
We describe the development of a preparative method to isolate molluscan catch muscle, calponin. This method is based on the ability of calponin to interact with actin in a temperature-dependent manner. After extracting thin filaments, as previously described, the extract was ultracentrifuged at 2 °C. While other surface proteins of thin filaments co-precipitated with actin, calponin, along with some minor contaminants, remained in the supernatant. Calponin was purified through cation-exchange chromatography. The yield of pure protein was four-fold higher than that achieved through high-temperature extraction. To evaluate functionally isolated proteins, we determined the effect of calponin on Mg2+-ATPase activity of hybrid and non-hybrid actomyosin. The degree of ATPase inhibition was consistent with previously published data but strongly dependent on the environmental conditions and source of actin and myosin used. Furthermore, at low concentrations, calponin could induce the ATPase activity of hybrid actomyosin. This result was consistent with data indicating that calponin can modulate actin conformation to increase the relative content of “switched on” actin monomers in thin filaments. We assume that calponin obtained by the isolation method proposed herein is a fully functional protein that can both inhibit and induce the ATPase activity.
Calponin
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Autoantibodies targeting intracellular proteins involved in key processes are detected in patients with idiopathic inflammatory myopathies. These myositis-specific autoantibodies have been increasingly demonstrated to correlate with distinct clinical phenotypes within the myositis spectrum. This review highlights the clinical associations of the myositis-specific autoantibodies, with particular attention to the recently identified and characterized novel myositis autoantibodies: p155/140, p140 (MJ), CADM-140 (MDA5), SAE, and 200/100.
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Calponin
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Muscle tension
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In recent years, the detection and characterization of (novel) autoantibodies is becoming increasingly important for the early diagnosis of autoimmune diseases. The idiopathic inflammatory myopathies (IIM, also indicated with myositis) are a group of systemic autoimmune disorders that involve inflammation and weakness of skeletal muscles. One of the hallmarks is the infiltration of inflammatory cells in muscle tissues. A number of myositis-specific autoantibodies have been identified and these may be associated with distinct IIM subclasses and clinical symptoms. Here, we review all myositis-specific autoantibodies identified today as well as their target proteins, together with their clinical associations in IIM patients. Post-translational modifications that might be associated with the generation of autoantibodies and the development of the disease are discussed as well. In addition, we describe well established autoantibody detection techniques that are currently being used in diagnostic laboratories, as well as novel multiplexed methods. The latter techniques provide great opportunities for the simultaneous detection of distinct autoantibodies, but may also contribute to the identification of novel autoantibody profiles, which may have additional diagnostic and prognostic value. The ongoing characterization of novel autoantibody specificities emphasizes the complexity of processes involved in the development of such autoimmune diseases.
Clinical Diagnosis
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The sera of about half of the patients with myositis contain autoantibodies that are specific for this group of diseases compared to other inflammatory connective tissue disorders. In a recent study we showed that these myositis specific autoantibodies (MSAs) are also specific for myositis as compared to other neuromuscular disorders. The most prevalent MSA, the anti-Jo-1 autoantibody, is associated with the anti-synthetase syndrome consisting of myositis, interstitial lung disease, arthritis, and Raynaud's phenomenon. The anti-Jo-1 autoantibody is generally not encountered in inclusion body myositis (IBM), and the presence of this autoantibody in serum of a patient suspected of myositis virtually rules out the diagnosis IBM. Rarely, anti-Jo-1 autoantibodies are seen in patients with definite IBM. These patients have a remarkable clinical characteristic: a significant response to corticosteroids whereas IBM in general does not respond to treatment. The reason for anti-Jo-1 autoantibody formation is unknown. Recently, it has been suggested that anti-Jo-1 autoantibodies may be directed against fragments of tRNAHis synthetase, the Jo-1 antigen, with a chemokine function. Two other MSAs, anti-Mi-2 and anti-SRP autoantibodies, are less prevalent than anti-Jo-1 and their clinical associations were not well defined. In two recent studies we showed that anti-SRP autoantibodies are a marker of an aggressive immune-mediated necrotizing myopathy whereas anti-Mi-2 autoantibodies are not associated with a particular form of myositis. Autoantibodies against a particular fragment of the Mi-2 antigen may be associated with an increased risk of an underlying malignancy. MSAs have helped recognizing some specific clinical subtypes of myositis. The ability to recognize these different forms of myositis is of importance because of differences in associated disorders, complications, treatment responses, and prognosis. Even though we still do not know the cause(s) of the myositis syndromes or the reason(s) for MSA formation, the MSAs have facilitated our thinking on the pathophysiology of myositis.
Inclusion body myositis
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Purpose of review Juvenile-onset myositis is a highly heterogeneous disease. Myositis-specific and associated autoantibodies provide a potential means of subdividing patients into clinically homogenous subgroups. Given the increasing availability of autoantibody testing, this review explores the phenotypes associated with different autoantibodies in juvenile-onset myositis and the potential clinical utility of autoantibody testing. Recent findings Autoantibodies can be identified in 60–70% of children with myositis and the recent discovery of novel myositis-associated autoantibodies in adult patients suggests this may increase in the near future. Detailed phenotype descriptions are now known for several autoantibodies commonly identified in juvenile-onset disease. Whilst there is insufficient evidence to recommend a differential treatment approach based on autoantibody status, it is becoming increasingly clear that some autoantibody subgroups are often treatment resistant and may benefit from a more aggressive approach. Summary The validation of nonspecialised methods for myositis-specific autoantibody detection should lead to more widely available testing. In juvenile-onset disease, this will provide detailed prognostic information and in the future may also influence approach.
Juvenile Dermatomyositis
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Purpose of review Idiopathic inflammatory myopathy is characterized by the production of autoantibodies to various cellular constituents. These autoantibodies closely correlate with certain clinical conditions and prognosis of disease. This review examines recent progress in myositis-specific autoantibodies, particularly in their clinical significance and pathophysiological roles. Recent findings During the 1-year review period, novel myositis-specific autoantibodies were identified in clinically amyopathic dermatomyositis (anti-CADM-140 antibody) and malignancy-associated myositis (anti-p155 and anti-p155/p140 antibodies). These new autoantibodies are extremely important because it is thought that myositis-specific autoantibodies are negative in these subgroups, and may enable a new classification of idiopathic inflammatory myopathy. New clinical aspects of other myositis-specific autoantibodies (anti-aminoacyl-tRNA synthetases, anti-signal recognition particles and anti-Mi-2) are also described. The possibility was raised that the high expression of myositis-specific autoantigens in regenerating muscle cells and certain cancers may be involved in initiating and perpetuating the autoimmune response in myositis. Summary Myositis-specific autoantibodies are useful markers for clinical diagnosis, classification and predicting prognosis of idiopathic inflammatory myopathy. To understand the etiopathogenic mechanisms of the disease it is particularly important to elucidate the nature of target autoantigens recognized by these myositis-specific autoantibodies.
Inclusion body myositis
Inflammatory myopathy
Clinical Significance
Pathophysiology
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OBJECTIVE
To determine the prevalence of myositis specificautoantibodies (MSAs) and several myositisassociated autoantibodies (MAAs) in a large group of patients with myositis.METHODS
A total of 417 patients with myositis from 11 European countries (198 patients with polymyositis (PM), 181 with dermatomyositis (DM), and 38 with inclusion body myositis (IBM)) were serologically analysed by immunoblot, enzyme linked immunosorbent assay (ELISA) and/or immunoprecipitation.RESULTS
Autoantibodies were found in 232 sera (56%), including 157 samples (38%) which contained MSAs. The most commonly detected MSA was anti-Jo-1 (18%). Other anti-synthetase, anti-Mi-2, and anti-SRP autoantibodies were found in 3%, 14%, and 5% of the sera, respectively. A relatively high number of anti-Mi-2 positive PM sera were found (9% of PM sera). The most commonly detected MAA was anti-Ro52 (25%). Anti-PM/Scl-100, anti-PM/Scl-75, anti-Mas, anti-Ro60, anti-La, and anti-U1 snRNP autoantibodies were present in 6%, 3%, 2%, 4%, 5%, and 6% of the sera, respectively. Remarkable associations were noticed between anti-Ro52 and anti-Jo-1 autoantibodies and, in a few sera, also between anti-Jo-1 and anti-SRP or anti-Mi-2 autoantibodies.CONCLUSIONS
The incidence of most of the tested autoantibody activities in this large group of European patients is in agreement with similar studies of Japanese and American patients. The relatively high number of PM sera with anti-Mi-2 reactivity may be explained by the use of multiple recombinant fragments spanning the complete antigen. Furthermore, our data show that some sera may contain more than one type of MSA and confirm the strong association of anti-Ro52 with anti-Jo-1 reactivity.Inclusion body myositis
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