Adaptive immune response to therapy in hmgcr autoantibody myopathy

Muscle Nerve. 2016 Feb;53(2):313-7. doi: 10.1002/mus.24947. Epub 2015 Dec 29.

Abstract

Introduction: We evaluated the response to immunosuppression in a case of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR)-autoantibody myopathy.

Methods: T- and B-cell subsets were determined by flow cytometry pre- and posttherapy.

Results: Baseline immune profiling demonstrated strikingly elevated T-follicular helper (Tfh) cells and plasmablasts. Immunosuppression resulted in clinical improvement and decreased Tfh cells, plasmablasts, and autoantibodies.

Conclusions: Immune profiling in HMGCR-autoantibody myopathy suggests a B-cell-mediated disease. Tfh cells and plasmablasts may be therapeutic biomarkers.

Keywords: B-cells; B-lymphocytes; HMGCR protein; T-cells; T-lymphocytes; autoimmunity; human; immune suppression; inflammatory myopathy.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptive Immunity / physiology*
  • Autoantibodies / immunology*
  • Humans
  • Hydroxymethylglutaryl CoA Reductases / immunology*
  • Male
  • Middle Aged
  • Muscular Diseases / immunology*
  • Muscular Diseases / therapy*
  • Neural Conduction / physiology

Substances

  • Autoantibodies
  • HMGCR protein, human
  • Hydroxymethylglutaryl CoA Reductases