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Journal of Immunology Research
Volume 2014, Article ID 405956, 8 pages
http://dx.doi.org/10.1155/2014/405956
Research Article

Analysis of Autoantibodies to 3-Hydroxy-3-methylglutaryl-coenzyme A Reductase Using Different Technologies

1Department of Immunology, Université Pierre et Marie Curie (AP-HP) Pitié-Salpêtrière Hospital, Paris, France
2Institute for Specialized Medicine, 4125 Sorrento Valley Blvd Suite A, Del Mar, San Diego, CA 92121, USA
3Inserm, U905 & Normandie University, IRIB, 76000 Rouen, France
4Department of Immunology, Rouen University Hospital, 76000 Rouen, France
5Department of Research, INOVA Diagnostics, INC., 9900 Old Grove Road, San Diego, CA 92131-1638, USA
6Departments of Neurology and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA

Received 22 November 2013; Accepted 10 January 2014; Published 5 March 2014

Academic Editor: Marvin J. Fritzler

Copyright © 2014 Lucile Musset et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.