title: Analysis of autoantibodies to 3-hydroxy-3-methylglutaryl-coenzyme A reductase using different technologies.
abstract: Diagnostic tests are needed to aid in the diagnosis of necrotizing myopathies associated with statin use. This study aimed to compare different technologies for the detection of anti-HMGCR antibodies and analyze the clinical phenotype and autoantibody profile of the patients. Twenty samples from myositis patients positive for anti-HMGCR antibodies using a research addressable laser bead assay and 20 negative controls were tested for autoantibodies to HMGCR: QUANTA Lite HMGCR ELISA and QUANTA Flash HMGCR CIA. All patients were also tested for antibodies to extractable nuclear antigens and myositis related antibodies. To verify the specificity of the ELISA, 824 controls were tested. All three assays showed qualitative agreements of 100% and levels of anti-HMGCR antibodies showed significant correlation: Spearman's rho > 0.8. The mean age of the anti-HMGCR antibody positive patients was 54.4 years, 16/20 were females, and 18/20 had necrotizing myopathy (two patients were not diagnosed). Nine out of 20 anti-HMGCR positive patients were on statin. All patients with anti-HMGCR antibodies were negative for all other autoantibodies tested. Testing various controls showed high specificity (99.3%). Anti-HMGCR antibodies are not always associated with the use of statin and appear to be the exclusive autoantibody specificity in patients with statin associated myopathies.
authors.affiliation: Department of Immunology, Université Pierre et Marie Curie (AP-HP) Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Lucile
authors.initials: L
authors.lastname: Musset
authors.affiliation: Department of Immunology, Université Pierre et Marie Curie (AP-HP) Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Makoto
authors.initials: M
authors.lastname: Miyara
authors.affiliation: Department of Immunology, Université Pierre et Marie Curie (AP-HP) Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Benveniste
authors.affiliation: Department of Immunology, Université Pierre et Marie Curie (AP-HP) Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Charuel
authors.affiliation: Institute for Specialized Medicine, 4125 Sorrento Valley Blvd Suite A, Del Mar, San Diego, CA 92121, USA.
authors.forename: Alexander
authors.identifier: 0000-0001-6179-3495
authors.initials: A
authors.lastname: Shikhman
authors.affiliation: Inserm, U905 & Normandie University, IRIB, 76000 Rouen, France ; Department of Immunology, Rouen University Hospital, 76000 Rouen, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Boyer
authors.affiliation: Department of Research, INOVA Diagnostics, INC., 9900 Old Grove Road, San Diego, CA 92131-1638, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Fowler
authors.affiliation: Departments of Neurology and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
authors.forename: Andrew
authors.identifier: 0000-0003-3732-3252
authors.initials: A
authors.lastname: Mammen
authors.affiliation: Department of Research, INOVA Diagnostics, INC., 9900 Old Grove Road, San Diego, CA 92131-1638, USA.
authors.forename: Joe
authors.initials: J
authors.lastname: Phillips
authors.affiliation: Department of Research, INOVA Diagnostics, INC., 9900 Old Grove Road, San Diego, CA 92131-1638, USA.
authors.forename: Michael
authors.identifier: 0000-0002-7919-0948
authors.initials: M
authors.lastname: Mahler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000595:Amino Acid Sequence; D001323:Autoantibodies / Q000097:blood* / Q000737:chemistry / Q000276:immunology*; D002460:Cell Line; D004797:Enzyme-Linked Immunosorbent Assay; D018604:Epitope Mapping; D000939:Epitopes / Q000737:chemistry / Q000276:immunology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000276:immunology*; D007118:Immunoassay / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000175:diagnosis / Q000276:immunology; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D000939:Epitopes; C553220:HMGCR protein, human; D006903:Hydroxymethylglutaryl CoA Reductases
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