Publications by authors named "Christopher A Mecoli"

Article Synopsis
  • Anti-HMGCR-positive immune-mediated necrotising myopathy (IMNM) is linked to IgG autoantibodies against HMGCR and specific HLA-DR alleles, but HMGCR-specific CD4T-cells had not been previously identified in affected patients.
  • This study demonstrated that patients with anti-HMGCR+IMNM show heightened CD4T-cell responses to HMGCR compared to those with dermatomyositis, with a significant correlation between these responses and the levels of anti-HMGCR antibodies.
  • The presence of distinct HMGCR-reactive CD4T-cells in both blood and muscle tissues highlights their potential role in the disease's development.
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates small bowel issues in systemic sclerosis (SSc) patients, finding that around 50% of these patients are affected, often severely.
  • Using statistical analysis, researchers compared clinical characteristics of SSc patients with and without small bowel abnormalities, revealing that those with issues were more likely to be male, had worse cardiac problems, and lower rates of dry mouth/eyes (sicca symptoms).
  • The study concludes that recognizing patients with abnormal small bowel transit can help in risk assessment and improving patient care, as these individuals showed higher mortality rates.
View Article and Find Full Text PDF
Article Synopsis
  • - The study aimed to analyze the frequency and relationship of two autoantibodies, anti-CCAR1 and anti-Sp4, in adult dermatomyositis (DM) patients and their link to cancer.
  • - Researchers studied data from 305 anti-TIF1γ-positive DM patients at Johns Hopkins and Stanford, discovering that about one-third were positive for each antibody, with 20% positive for both.
  • - Results indicated that those without anti-Sp4 or anti-CCAR1 had a stronger association with cancer, whereas patients positive for either antibody had a lower risk; nevertheless, half of the patients were negative for both and may need closer cancer monitoring.
View Article and Find Full Text PDF

Objective: This study aims to evaluate the diagnostic accuracy of CA-125 and PET/CT in detecting cancer among adult patients with idiopathic inflammatory myopathy (IIM).

Methods: We conducted a retrospective study of a single-centre cohort of adult IIM patients enrolled from 2003 to 2020. Data on CA-125 and PET/CT tests conducted within five years of IIM symptom onset were extracted from electronic medical records.

View Article and Find Full Text PDF

Background: Validated patient-reported outcome measures to assess disease impact in patients with adult idiopathic inflammatory myopathies (IIMs) are needed. The objective of this study was to assess the construct validity of PROMIS Pain Interference, Fatigue, and Physical Function measures in comparison with core disease activity measures.

Methods: Adults with IIM, excluding inclusion body myositis, from OMERACT Myositis Working Group (MWG) clinic sites completed PROMIS Short Form v1.

View Article and Find Full Text PDF

Background: International focus groups with patients with idiopathic inflammatory myopathies (IIM) conducted by the OMERACT Myositis Working Group over the years demonstrated the pain as an important symptom experienced by these patients. In this study, we aimed to examine the frequency and degree of pain interference, the aspects of daily life impacted by pain, and the factors associated with pain interference in adults with IIM.

Methods: This was a prospective observational study with two visits.

View Article and Find Full Text PDF

Myositis International Health and Research Collaborative Alliance (MIHRA) is a newly formed purpose-built non-profit charitable research organization dedicated to accelerating international clinical trial readiness, global professional and lay education, career development and rare disease advocacy in IIM-related disorders. In its long form, the name expresses the community's scope of engagement and intent. In its abbreviation, MIHRA, conveys linguistic roots across many languages, that reflects the IIM community's spirit with meanings such as kindness, community, goodness, and peace.

View Article and Find Full Text PDF

Objective: To determine the clinical phenotype and outcomes of patients with idiopathic inflammatory myopathies (IIMs) and myocarditis.

Methods: Using the Johns Hopkins Myositis Center Research Registry, we identified 31 adult patients with IIM-out of a total of 3082 with confirmed or suspected muscle disease-with an encounter code of myocarditis from 2004 to 2021. Of these, 14 adult patients with IIM were adjudicated to have clinical myocarditis.

View Article and Find Full Text PDF

Objective: To inform guidance for cancer detection in patients with idiopathic inflammatory myopathy (IIM), we evaluated the diagnostic yield of computed tomography (CT) imaging for cancer screening/surveillance within distinct IIM subtypes and myositis-specific autoantibody strata.

Methods: We conducted a single-center, retrospective cohort study in IIM patients. Overall diagnostic yield (number of cancers diagnosed/number of tests performed), percentage of false positives (number of biopsies performed not leading to cancer diagnosis/number of tests performed), and test characteristics were determined on CT of the chest and abdomen/pelvis.

View Article and Find Full Text PDF

Objective: To describe the disease specificity, clinical phenotype, and risk of cancer in dermatomyositis (DM) patients with autoantibodies against cell division cycle and apoptosis regulator protein 1 (anti-CCAR1).

Methods: The frequency of anti-CCAR1 autoantibodies was measured by enzyme-linked immunosorbent assay in the serum of DM patients from 2 independent cohorts (Johns Hopkins and Stanford), with patients with several other rheumatic diseases and healthy controls used as comparators. Clinical features and the risk of cancer incidence relative to that in the general population were determined in anti-CCAR1-positive DM patients.

View Article and Find Full Text PDF

Background And Objectives: Sporadic inclusion body myositis (IBM) is the most common acquired myopathy in individuals older than 50 years. The disorder is slowly progressive, and although many therapies have been investigated, response has generally been poor. Clinical heterogeneity may influence treatment responsiveness; however, data regarding heterogeneity in IBM are limited and often conflicting.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess the effectiveness and reliability of PROMIS instruments that measure pain interference, fatigue, and physical function in patients with idiopathic inflammatory myopathies (IIM).
  • Analysis involved completing surveys from 368 participants, where the instruments met 10 out of 13 hypotheses for construct validity, showing strong test-retest reliability and excellent internal consistency.
  • Results indicated that the PROMIS instruments were effective measures for IIM patients, although the Pain Interference tool exhibited a ceiling effect, meaning it might not capture extreme levels of pain interference adequately.
View Article and Find Full Text PDF

Objectives: In dermatomyositis (DM), autoantibodies are associated with unique clinical phenotypes. For example, anti-TIF1γ autoantibodies are associated with an increased risk of cancer. The purpose of this study was to discover novel DM autoantibodies.

View Article and Find Full Text PDF

Background: Anti-melanoma differentiation-associated gene 5 (anti-MDA5) antibodies in patients with dermatomyositis are associated with rapidly progressive interstitial lung disease (RP-ILD). Computed tomography (CT) plays a central role in the diagnosis of RP-ILD and may help characterize the temporal changes.

Methods: We report five anti-MDA5-positive dermatomyositis patients with serial CT scans spanning their acute RP-ILD disease course.

View Article and Find Full Text PDF

Objective: This study investigates cancer risk in idiopathic inflammatory myopathy (IIM) relative to the general population.

Methods: We conducted a single-center, retrospective cohort study of IIM patients and malignancy. Myositis-specific and -associated autoantibodies were determined by Euroimmun line blot, enzyme-linked immunosorbent assay, and immunoprecipitation.

View Article and Find Full Text PDF

BackgroundSome clinical features of severe COVID-19 represent blood vessel damage induced by activation of host immune responses initiated by the coronavirus SARS-CoV-2. We hypothesized autoantibodies against angiotensin-converting enzyme 2 (ACE2), the SARS-CoV-2 receptor expressed on vascular endothelium, are generated during COVID-19 and are of mechanistic importance.MethodsIn an opportunity sample of 118 COVID-19 inpatients, autoantibodies recognizing ACE2 were detected by ELISA.

View Article and Find Full Text PDF

Objective: Patients with anti-melanoma-differentiation-associated 5 (anti-MDA5)-positive dermatomyositis (DM) share several striking similarities to patients with SARS-CoV-2. Our objective was to assess the prevalence of anti-angiotensin converting enzyme-2 (ACE2) immunoglobulin M (IgM) antibodies, found in patients with severe SARS-CoV-2, in two independent anti-MDA5-positive DM cohorts.

Methods: Anti-ACE2 IgM antibodies were assayed by enzyme-linked immunosorbent assay (ELISA) in two anti-MDA5-positive DM cohorts: a predominantly outpatient North American cohort (n = 52) and a Japanese cohort enriched for new-onset disease (n = 32).

View Article and Find Full Text PDF

Objective: To determine whether perifollicular hypopigmentation in systemic sclerosis (SSc) is associated with demographics, distinct clinical features, and autoantibody profiles.

Methods: Patients with SSc were prospectively enrolled, with a standardized data form used to collect anatomic distribution of perifollicular hypopigmentation. Associations between hypopigmentation and features of SSc were assessed.

View Article and Find Full Text PDF

BACKGROUNDThe temporal clustering of a cancer diagnosis with dermatomyositis (DM) onset is strikingly associated with autoantibodies against transcriptional intermediary factor 1-γ (TIF1-γ). Nevertheless, many patients with anti-TIF1-γ antibodies never develop cancer. We investigated whether additional autoantibodies are found in anti-TIF1-γ-positive patients without cancer.

View Article and Find Full Text PDF

Objective: We undertook this study to 1) determine the sensitivity of the European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) classification criteria for idiopathic inflammatory myopathies (IIMs) to properly classify myositis-specific autoantibody (MSA)-positive myositis patients, 2) describe the phenotype and muscle involvement over time in different MSA-positive patients, and 3) compare MSA subgroups to EULAR/ACR criteria-defined myositis subgroups for their capacity to predict clinical phenotypes in patients with IIMs.

Methods: The study included 524 MSA-positive myositis patients from the Johns Hopkins Myositis Center. Each patient was classified using the EULAR/ACR classification criteria.

View Article and Find Full Text PDF
Article Synopsis
  • A study assessed the prevalence of avascular necrosis (AVN) in patients with idiopathic inflammatory myopathies (IIM) by reviewing medical records from 2003 to 2020.
  • Out of 1680 IIM patients, 51 developed AVN, leading to a prevalence of 3%, with MRI results showing a slightly higher prevalence of 4.2%.
  • Most affected patients were Caucasian females with a median age of 44.5 years, and despite the prevalence, 81% were asymptomatic; established AVN risk factors were not linked to its occurrence in this group.
View Article and Find Full Text PDF