CONGRESS 2023 - Myositis antibodies: are we missing something?
A myositis-related autoantibody can now be identified in the majority of patients with myositis. They identify homogeneous patient subgroups and are key tools in developing a personalised approach to disease management. There is substantial clinical interest in exploiting myositis autoantibodies as biomarkers, and consequently, a large number of commercial assays have been developed for their detection. Several different commercial assays have now been developed to detect myositis relevant autoantibodies. Many have been developed with the practicalities of clinical practice in mind, offering rapid, affordable, and often multiplex testing. Despite this progress, the perfect system has yet to be realised. Commercial testing systems do not detect all known myositis relevant autoantibodies and concerns have been raised about the sensitivity and specificity of some assays, including to their ability detect some autoantibodies strongly associated with malignancy and ILD; important causes of mortality and morbidity. The advantages and disadvantages of different myositis autoantibody testing systems will be discussed. Evidence for the reliability of different types of assays in comparison to immunoprecipitation, as the reference standard, will be reviewed along with testing strategies that make the most of existing technology.
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A myositis-related autoantibody can now be identified in the majority of patients with myositis. They identify homogeneous patient subgroups and are key tools in developing a personalised approach to disease management. There is substantial clinical interest in exploiting myositis autoantibodies as biomarkers, and consequently, a large number of commercial assays have been developed for their detection. Several different commercial assays have now been developed to detect myositis relevant autoantibodies. Many have been developed with the practicalities of clinical practice in mind, offering rapid, affordable, and often multiplex testing. Despite this progress, the perfect system has yet to be realised.
Commercial testing systems do not detect all known myositis relevant autoantibodies and concerns have been raised about the sensitivity and specificity of some assays, including to their ability detect some autoantibodies strongly associated with malignancy and ILD; important causes of mortality and morbidity.
The advantages and disadvantages of different myositis autoantibody testing systems will be discussed. Evidence for the reliability of different types of assays in comparison to immunoprecipitation, as the reference standard, will be reviewed along with testing strategies that make the most of existing technology.