Yoshida Naomi, Okamoto Masaki, Kaieda Shinjiro, Fujimoto Kiminori, Ebata Tomohiro, Tajiri Morihiro, Nakamura Masayuki, Tominaga Masaki, Wakasugi Daisuke, Kawayama Tomotaka, Kuwana Masataka, Mimori Tsuneyo, Ida Hiroaki, Hoshino Tomoaki
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan.
Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan.
Respir Investig. 2017 Jan;55(1):24-32. doi: 10.1016/j.resinv.2016.08.007. Epub 2016 Sep 30.
We attempted to clarify whether the presence of anti-aminoacyl-transfer RNA synthetase antibody (anti-ARS Ab) or anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab) is associated with the therapeutic response of polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD).
We retrospectively investigated 22 patients with PM/DM-ILD (10 positive for anti-ARS Ab and nine positive for anti-MDA5 Ab) for whom antibody analysis of conserved serum was possible. We assessed mortality in the first three months as the therapeutic response in the acute phase and compared changes in clinical data for up to one year considered as the chronic phase. We classified the clinical changes over the year into three groups: Improvement (increased % vital capacity [%VC] or diffusing capacity of the lung for carbon monoxide [%D]≥10 or 15%), deterioration (decreased %VC or %D≥10 or 15%), and no change (remainder of the changes). The extent of abnormality demonstrated by high-resolution computed tomography (HRCT) was scored.
Positivity for anti-MDA5 Ab, but not for anti-ARS Ab, was associated with mortality in the first 3 months. Evaluation of the therapeutic response in the first year showed that positivity for the anti-ARS Ab, but not for the anti-MDA5 Ab, was associated with an improvement in %D and a decline in the serum KL-6 levels. Positivity for the anti-ARS Ab or negativity for anti-MDA5 Ab was associated with a greater decrease in bronchial dilatation as seen by HRCT.
Anti-ARS and anti-MDA5 Abs are associated with the therapeutic response of PM/DM-ILD.
我们试图阐明抗氨酰 - 转移RNA合成酶抗体（抗ARS抗体）或抗黑色素瘤分化相关基因5抗体（抗MDA5抗体）的存在是否与多发性肌炎/皮肌炎相关间质性肺病（PM/DM-ILD）的治疗反应相关。
我们回顾性研究了22例PM/DM-ILD患者（10例抗ARS抗体阳性，9例抗MDA5抗体阳性），这些患者能够进行保存血清的抗体分析。我们将前三个月的死亡率评估为急性期的治疗反应，并比较了长达一年（视为慢性期）的临床数据变化。我们将一年中的临床变化分为三组：改善（肺活量百分比[%VC]增加或肺一氧化碳弥散量[%D]≥10或15%）、恶化（%VC降低或%D≥10或15%）和无变化（其余变化情况）。对高分辨率计算机断层扫描（HRCT）显示的异常程度进行评分。
抗MDA5抗体阳性而非抗ARS抗体阳性与前3个月的死亡率相关。对第一年治疗反应的评估表明，抗ARS抗体阳性而非抗MDA5抗体阳性与%D的改善和血清KL-6水平的下降相关。抗ARS抗体阳性或抗MDA5抗体阴性与HRCT显示的支气管扩张更大程度的减轻相关。
抗ARS和抗MDA5抗体与PM/DM-ILD的治疗反应相关。
