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. 2009 Aug;60(8):2499-504.
doi: 10.1002/art.24702.

Ultraviolet radiation intensity predicts the relative distribution of dermatomyositis and anti-Mi-2 autoantibodies in women

Lori A Love  1 , Clarice R Weinberg, D Robert McConnaughey, Chester V Oddis, Thomas A Medsger Jr, John D Reveille, Frank C Arnett, Ira N Targoff, Frederick W Miller
Affiliations

Ultraviolet radiation intensity predicts the relative distribution of dermatomyositis and anti-Mi-2 autoantibodies in women

Lori A Love et al. Arthritis Rheum. 2009 Aug.

Abstract

Objective: Because studies suggest that ultraviolet (UV) radiation modulates the myositis phenotype and Mi-2 autoantigen expression, we conducted a retrospective investigation to determine whether UV radiation may influence the relative prevalence of dermatomyositis and anti-Mi-2 autoantibodies in the US.

Methods: We assessed the relationship between surface UV radiation intensity in the state of residence at the time of onset with the relative prevalence of dermatomyositis and myositis autoantibodies in 380 patients with myositis from referral centers in the US. Myositis autoantibodies were detected by validated immunoprecipitation assays. Surface UV radiation intensity was estimated from UV Index data collected by the US National Weather Service.

Results: UV radiation intensity was associated with the relative proportion of patients with dermatomyositis (odds ratio [OR] 2.3, 95% confidence interval [95% CI] 0.9-5.8) and with the proportion of patients expressing anti-Mi-2 autoantibodies (OR 6.0, 95% CI 1.1-34.1). Modeling of these data showed that these associations were confined to women (OR 3.8, 95% CI 1.3-11.0 and OR 17.3, 95% CI 1.8-162.4, respectively) and suggests that sex influences the effects of UV radiation on autoimmune disorders. Significant associations were not observed in men, nor were UV radiation levels related to the presence of antisynthetase or anti-signal recognition particle autoantibodies.

Conclusion: This first study of the distribution of myositis phenotypes and UV radiation exposure in the US showed that UV radiation may modulate the clinical and immunologic expression of autoimmune disease in women. Further investigation of the mechanisms by which these effects are produced may provide insights into pathogenesis and suggest therapeutic or preventative strategies.

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Figures

Figure 1
Figure 1
Associations between the annual UV Index in seven U.S. regions and the proportion of patients with dermatomyositis (DM) and anti-Mi-2 autoantibodies in each region. Modeling of these data for all myositis patients based on state of residence showed a non-significant trend for association between the UV index and the logit of the proportion of DM patients (p=0.07, upper left panel), but a significant association with the logit of the proportion of those with anti-Mi-2 autoantibodies (p=0.05, upper right panel). The data suggest that these associations are driven by women (for DM, p=0.014, lower left panel; for anti-Mi-2 autoantibodies, p=0.012, lower right panel). Because no patients with anti-Mi-2 autoantibodies were in the Northwest region, this region is not represented in the right two panels. The size of the circle representing each region is proportional to the number of patients residing in that region at the time of myositis onset.
See this image and copyright information in PMC

References

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