Microbial and autoantibody immunogenic repertoires in TIF1? autoantibody positive dermatomyositis

Spyridon Megremis; Thomas Walker; Xiaotong He; James O'Sullivan; William E.R. Ollier; Hector Chinoy; Neil Pendleton; Antony Payton; Lynne Hampson; Ian Hampson; Janine Lamb

The use of pooled plasma is a limitation in our study since we cannot deconvolute the data into individual patients. However, the enrichment process against healthy adults provides a unique opportunity to study DM as a disease system capturing the breadth of microbial antibody and autoantibody accumulation against a very large number of linear epitopes. Apart from antibodies against TIF1 which is a shared feature of the patients in this study, we do not anticipate that our findings will be equally distributed among patients. Indeed, if the shared feature in DM is a molecular mimicry . CC-BY-ND 4.0 International license author/funder. It is made available under a The copyright holder for this preprint (which was not peer-reviewed) is the . https://doi.org/10.1101/2020.03.25.007534 doi: bioRxiv preprint event combined with epitope spreading, then the stochastic nature of microbial exposure, genetic predisposition and the dynamic nature of immunity would not support a single pathotype. Thus, our study provides the first DM-specific "map" of potential routes to disease. For the future, we recommend: clinical records are kept of short and long-term microbial exposure, infections history including type of pathogen, severity scores, number of hospitalisations and vaccination history; which were not available in this study. Records could be expanded in cases of juvenile DM, to include maternal infection and vaccination history to account for acquired transplacental immunity.