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However, although broadly applied, substantial bias is imposed by the respective methods, observers and individual staining approaches. We aimed to quantify the protein levels of major histocompatibility complex (MHC)\u20101, (MHC)\u20102 and intercellular adhesion molecule (ICAM)\u20101 using an automated morphometric method to mitigate bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Double immunofluorescence staining was performed on whole muscle sections to study differences in protein expression in myofibre and endomysial vessels. We analysed all IIM subtypes including dermatomyositis (DM), anti\u2010synthetase syndrome (ASyS), inclusion body myositis (IBM), immune\u2010mediated\u2010necrotising myopathy (IMNM), dysferlinopathy (DYSF), SARS\u2010CoV\u20102 infection and vaccination\u2010associated myopathy. Biopsies with neurogenic atrophy (NA) and normal morphology served as controls. Bulk RNA\u2010Sequencing (RNA\u2010Seq) was performed on a subset of samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our study highlights the significance of MHC\u20101, MHC\u20102 and ICAM\u20101 in diagnosing IIM subtypes and reveals distinct immunological profiles. RNASeq confirmed the precision of our method and identified specific gene pathways in the disease subtypes.<\/jats:p><jats:p>Notably, ASyS, DM and SARS\u2010CoV\u20102\u2010associated myopathy showed increased ICAM\u20101 expression in the endomysial capillaries, indicating ICAM\u20101\u2010associated vascular activation in these conditions. In addition, ICAM\u20101 showed high discrimination between different subgroups with high sensitivity and specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Automated morphometric analysis provides precise quantitative data on immune\u2010associated proteins that can be integrated into our pathophysiological understanding of IIM. Further, ICAM\u20101 holds diagnostic value for the detection of IIM pathology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nan.12998","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T08:29:22Z","timestamp":1721377762000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Differentiating idiopathic inflammatory myopathies by automated morphometric analysis of MHC\u20101, MHC\u20102 and ICAM\u20101 in muscle tissue"],"prefix":"10.1111","volume":"50","author":[{"given":"Anna","family":"Nishimura","sequence":"first","affiliation":[{"name":"Institute of Neuropathology Justus\u2010Liebig University Giessen  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Nelke","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical Faculty and University Hospital D\u00fcsseldorf Heinrich\u2010Heine\u2010University  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology Campus Kerckhoff Justus\u2010Liebig\u2010University, Giessen  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0089-4473","authenticated-orcid":false,"given":"Alexander","family":"Mensch","sequence":"additional","affiliation":[{"name":"Department of Neurology University Medicine Halle  Halle (Saale) Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Roth","sequence":"additional","affiliation":[{"name":"Institute of Neuropathology Justus\u2010Liebig University Giessen  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Oberwittler","sequence":"additional","affiliation":[{"name":"Department of Neurology St. Vincenz Hospital  Limburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Zimmerlein","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital Nordwest  Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidrun H.","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"Department of Neurology Justus\u2010Liebig\u2010University, Giessen  Germany"},{"name":"Translational Neuroscience Network Giessen (TNNG) Justus Liebig University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Neuen\u2010Jacob","sequence":"additional","affiliation":[{"name":"Institute of Neuropathology Heinrich\u2010Heine\u2010University  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1143-2103","authenticated-orcid":false,"given":"Werner","family":"Stenzel","sequence":"additional","affiliation":[{"name":"Department of Neuropathology Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"M\u00fcller\u2010Ladner","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology Campus Kerckhoff Justus\u2010Liebig\u2010University, Giessen  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Ruck","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical Faculty and University Hospital D\u00fcsseldorf Heinrich\u2010Heine\u2010University  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2014-2028","authenticated-orcid":false,"given":"Anne","family":"Sch\u00e4nzer","sequence":"additional","affiliation":[{"name":"Institute of Neuropathology Justus\u2010Liebig University Giessen  Germany"},{"name":"Translational Neuroscience Network Giessen (TNNG) Justus Liebig University Giessen  Giessen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","unstructured":"AllenbachY BenvenisteO GoebelHH StenzelW.Integrated classification of inflammatory myopathies. 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