medicina57巻12号

2020年11月発行

特集 膠原病・自己免疫疾患を「見える化」する 臨床から見える化する 【筋炎】

自己抗体で筋炎を見える化する

著者： 濱口儒人¹

所属機関： ¹金沢大学医薬保健研究域医学系皮膚分子病態学

ページ範囲：P.2106 - P.2109

Point
◎多発性筋炎/皮膚筋炎では，筋炎特異的自己抗体（MSA）と臨床症状に関連がある．
◎いくつかのMSAはELISA検査試薬が開発されているが，それ以外は同定に免疫沈降法が必要である．
◎MSAを同定するには，蛍光抗体間接法とELISA検査の結果が一致するかを確認する．

参考文献

1）Sato S, et al：Autoantibodies to a 140-kd polypeptide, CADM-140, in Japanese patients with clinically amyopathic dermatomyositis. Arthritis Rheum 52：1571-1576, 2005

2）Kaji K, et al：Identification of a novel autoantibody reactive with 155 and 140 kDa nuclear proteins in patients with dermatomyositis；An association with malignancy. Rheumatology（Oxford）46：25-28, 2007

3）Hamaguchi Y, et al：Performance evaluation of a commercial line blot assay system for detection of myositis- and systemic sclerosis-related autoantibodies. Clin Rheumatol, 2020（epub ahead of print）

4）Targoff IN：Autoantibodies in polymyositis. Rheum Dis Clin North Am 18：455-482, 1992

5）Hamaguchi Y, et al：Common and distinct clinical features in adult patients with anti-aminoacyl-tRNA synthetase antibodies；Heterogeneity within the syndrome. PLoS One 8：e60442, 2013

6）Komura K, et al：Prevalence and clinical characteristics of anti-Mi-2 antibodies in Japanese patients with dermatomyositis. J Dermatol Sci 40：215-217, 2005

7）Tsuji H, et al：Multicenter prospective study of the efficacy and safety of combined immunosuppressive therapy with high-dose glucocorticoid, tacrolimus, and cyclophosphamide in interstitial lung diseases accompanied by anti-melanoma differentiation-associated gene 5-positive dermatomyositis. Arthritis Rheumatol 72：488-498, 2020

8）Matsushita T, et al：Antimelanoma differentiation-associated protein 5 antibody level is a novel tool for monitoring disease activity in rapidly progressive interstitial lung disease with dermatomyositis. Br J Dermatol 176：395-402, 2017

9）Ichimura Y, et al：Anti-NXP2 autoantibodies in adult patients with idiopathic inflammatory myopathies；Possible association with malignancy. Ann Rheum Dis 71：710-713, 2012

10）Fujimoto M, et al：Autoantibodies to small ubiquitin-like modifier activating enzymes in Japanese patients with dermatomyositis；Comparison with a UK Caucasian cohort. Ann Rheum Dis 72：151-153, 2013

11）Suzuki S, et al：Clinical utility of anti-signal recognition particle antibody in the differential diagnosis of myopathies. Rheumatology（Oxford）47：1539-1542, 2008