Current understanding and recent advances in myositis-specific and -associated autoantibodies detected in patients with dermatomyositis

Introduction: Dermatomyositis (DM) is characterized by skin lesions, such as heliotrope rash and Gottron's papules/sign, and skeletal myopathy. Patients with DM often have arthritis, cardiomyopathy, interstitial lung disease (ILD), and concomitant malignancy. Since clinical characteristics, treatment response, and prognosis are highly variable among patients, it is critical to predict future outcomes in DM patients before the initiation of management. Recently, a number of myositis-specific and -associated autoantibodies (MSAs/MAAs) have been identified and well characterized, and commercial assays for their detection have become available.Areas covered: There is accumulating evidence showing the utility of MSAs/MAAs in diagnosis of DM and in predicting clinical courses and outcomes in patients with DM as convenient biomarkers, i.e. an association of ILD with anti-ARS, anti-MDA5 and anti-SAE; and malignancy with anti-TIF1-γ, anti-NXP2, and anti-SAE in adults. This review describes available assays employed for the detection of MSAs/MAAs and how to integrate autoantibody results into clinical practice of DM patients, mainly adult patients. The relevant literature was searched on PubMed as of 2 November 2019.Expert opinion: MSAs/MAAs are convenient biomarkers that are useful in personalized medicine and thus should be adopted in routine clinical practice of patients with DM, but in a science-based manner.