Background

Several complications like calcinosis, interstitial lung disease (ILD) or malignancy, are primary causes leading to poor outcomes in idiopathic inflammatory myopathies (IIM) patients. Specific antibodies might help to indicate the occurrence or absence of these complications.

Objective

The aim of this study was to evaluate the association of anti-nuclear matrix protein 2 antibody (anti-NXP2) with calcinosis, ILD and malignancy in IIM patients.

Methods

Two investigators independently searched literature about the relation of anti-NXP2 with calcinosis, ILD, malignancy in IIM patients in PubMed, EMBASE, Web of Science databases, then selected eligible articles and extracted data from the included studies. The association between anti-NXP2 and these complications was assessed by odds ratios (OR) and 95% confidence intervals (95% CI). Further quantitative meta-analysis, subgroup analysis, sensitivity analysis and publication bias analysis were conducted with STATA 14.0 software (Stata Corp.; College Station, Texas, USA). A fixed-effects model (the Mantel-Haenszel method) was employed when I² < 25%, otherwise a random-effects model (the Mantel-Haenszel method) was used.

Results

Twenty cohorts with 3064 IIM patients were included in this meta-analysis, among which 9 were about calcinosis in adults, 6 about calcinosis in juvenile patients, 9 about ILD in adults, 3 about ILD in juvenile patients, while 13 about malignancy in adult patients. Anti-NXP2 was more common in patients with calcinosis than those without calcinosis (pooled OR = 4.00, 95% CI: 2.65–6.06 in adults; pooled OR = 1.62, 95% CI: 1.14–2.30 in juvenile patients). On the contrary, this antibody was less common in adult patients with ILD than those without ILD (pooled OR: 0.33, 95% CI: 0.19–0.56). No significant difference concerning the incidence of anti-NXP2 antibody was found in IIM patients between those with and without cancer (pooled OR = 1.42, 95% CI: 0.69–2.91).

Conclusion

The present study indicates that anti-NXP2 autoantibody is a risk factor for development into calcinosis both in adult and juvenile patients, while a protective factor for ILD in adult patients. Anti-NXP2 had no relation with malignancy in adult patients.

中文翻译：

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抗核基质蛋白2抗体与特发性炎症性肌病患者并发症的关联：对20个队列的荟萃分析

背景

钙化病，间质性肺病（ILD）或恶性肿瘤等几种并发症是导致特发性炎症性肌病（IIM）患者预后不良的主要原因。特异性抗体可能有助于指示这些并发症的发生或不存在。

客观的

这项研究的目的是评估IIM患者的抗核基质蛋白2抗体（anti-NXP2）与煅烧，ILD和恶性肿瘤的关系。

方法

两名研究者在PubMed，EMBASE，Web of Science数据库中独立搜索了有关抗NXP2与煅烧，ILD，IIM患者恶性肿瘤之间关系的文献，然后选择了符合条件的文章并从纳入的研究中提取了数据。通过比值比（OR）和95％置信区间（95％CI）评估抗NXP2与这些并发症之间的关联。使用STATA 14.0软件（Stata Corp .；美国德克萨斯州学院站）进行了进一步的定量荟萃分析，亚组分析，敏感性分析和出版物偏倚分析。当I ²  <25％时，使用固定效应模型（Mantel-Haenszel方法），否则使用随机效应模型（Mantel-Haenszel方法）。

结果

这项荟萃分析包括20个队列，共3064名IIM患者，其中9例涉及成人钙化，6例涉及青少年钙化，9例涉及成人ILD，3例涉及青少年ILD，13例涉及成人恶性肿瘤。 。抗NXP2在有钙化病的患者中比没有无钙化病的患者更为常见（成人合并OR = 4.00，95％CI：2.65–6.06；合并OR = 1.62，95％CI：1.14–2.30）。相反，该抗体在患有ILD的成年患者中比没有ILD的患者少见（合并OR：0.33，95％CI：0.19-0.56）。在有和没有癌症的IIM患者中，关于抗NXP2抗体的发生率没有显着差异（合并OR = 1.42，95％CI：0.69–2.91）。

结论

本研究表明，抗NXP2自身抗体是成年和未成年患者发展为煅烧的危险因素，而成年患者则为ILD的保护因子。抗NXP2与成人患者的恶性肿瘤无关。