Local immunoglobulin expression in myositis is associated with interferon gamma signaling and correlates with disease activity.

Objectives: Autoantibodies may play a role in the pathogenesis of myositis and are locally produced within muscle tissue. This study aimed to characterize the local expression of immunoglobulin genes across different subgroups of myositis, identify pathways associated with this expression, and evaluate correlations with disease activity.

Methods: Bulk RNA sequencing was performed on muscle biopsies from 289 individuals, including patients with various forms of myositis and healthy controls. Expression levels of immunoglobulin gene regions were compared across clinical and autoantibody-defined subgroups. Pathway enrichment analysis and unsupervised clustering were conducted, and correlations between immunoglobulin gene expression and disease activity were assessed.

Results: Local immunoglobulin gene expression was highest in inclusion body myositis (IBM) and antisynthetase syndrome (ASyS), followed by dermatomyositis, and lowest in immune-mediated necrotizing myopathy. Among isotypes, IgG, IgA, and IgM predominated, while IgD and IgE expression was minimal. Certain immunoglobulin VJ segments were more frequently used across all patients, with no significant differences in specific region usage between patient groups. Immunoglobulin gene expression strongly correlated with disease activity, particularly in patients with anti-Mi2, anti-MDA5, anti-Jo1 autoantibodies, and IBM. Pathway analysis revealed a robust association between immunoglobulin expression and interferon-gamma (IFN-γ) signaling. Unsupervised clustering based solely on immunoglobulin gene expression clearly separated healthy controls from patients with ASyS and IBM.

Conclusions: Immunoglobulin is locally expressed in the muscle of patients with myositis, particularly IBM and ASyS. This expression correlates with disease activity, involves preferential usage of specific isotypes and gene segments, and is closely linked to IFN-γ-associated immune pathways.