抗氨酰基-tRNA 合成酶与抗 SS-A/Ro52 抗体在多发性肌炎/皮肌炎患者中的聚类分析。

Cluster Analysis Using Anti-Aminoacyl-tRNA Synthetases and SS-A/Ro52 antibodies in Patients With Polymyositis/Dermatomyositis.

机构信息

From the Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.

Medical School, Okayama University, Okayama, Japan.

出版信息

J Clin Rheumatol. 2019 Sep;25(6):246-251. doi: 10.1097/RHU.0000000000000836.

DOI:10.1097/RHU.0000000000000836

PMID:29933322

Abstract

OBJECTIVE

Although several autoantibodies have been identified for polymyositis/dermatomyositis (PM/DM) diagnosis, the clinical impact of these antibodies is yet to be elucidated.

METHODS

Patients with PM/DM at Okayama University Hospital from 2012 to 2016 were historically enrolled, and antibody profiles were analyzed using line immunoassay. Hierarchical cluster analysis was performed based on serological analysis of anti-aminoacyl-tRNA synthetase (ARS) antibodies, including anti-Jo-1, PL-7, PL-12, EJ, OJ, and SS-A/Ro-52 antibodies. Clinical symptoms and relapse proportions were compared among these clusters.

RESULTS

Sixty-one patients were enrolled in this study: 28 were diagnosed with PM, and 33 were diagnosed with DM. The following 3 clusters were determined: 1 (n = 10), anti-Jo-1 and anti-SS-A/Ro-52 antibodies double positive (10/10, 100%); 2 (n = 24), anti-SS-A/Ro-52 antibody positive (20/24, 83%), anti-Jo-1 antibody negative (24/24, 100%), and anti-ARS antibodies (excluding anti-Jo-1 antibody) positive (15/24, 63%); and 3 (n = 27), anti-Jo-1 and anti-SS-A/Ro52 antibodies double negative (26/27, 96%). The proportion of patients who relapsed was significantly lower in cluster 3 than it was in clusters 1 and 2 (risk ratio, 0.37; 95% confidence interval, 0.17-0.83; p = 0.026 and risk ratio, 0.42; 95% confidence interval, 0.20-0.89; P = 0.019, respectively). There was no difference in the proportion of relapsed patients between clusters 1 and 2.

CONCLUSIONS

Our cluster analysis shows that anti-SS-A/Ro52 or any anti-ARS antibodies or both might be relevant to clinical outcomes.

摘要

目的

尽管已鉴定出多种用于多发性肌炎/皮肌炎（PM/DM）诊断的自身抗体，但这些抗体的临床意义仍有待阐明。

方法

回顾性分析 2012 年至 2016 年在冈山大学医院就诊的 PM/DM 患者，采用线免疫分析法分析抗体谱。基于抗氨酰-tRNA 合成酶（ARS）抗体的血清学分析（包括抗 Jo-1、PL-7、PL-12、EJ、OJ 和 SS-A/Ro-52 抗体）进行层次聚类分析。比较这些聚类之间的临床症状和复发比例。

结果

本研究共纳入 61 例患者：28 例诊断为 PM，33 例诊断为 DM。确定了以下 3 个聚类：1 （n=10），抗 Jo-1 和抗 SS-A/Ro-52 抗体双阳性（10/10，100%）；2 （n=24），抗 SS-A/Ro-52 抗体阳性（20/24，83%），抗 Jo-1 抗体阴性（24/24，100%），抗 ARS 抗体（不包括抗 Jo-1 抗体）阳性（15/24，63%）；3 （n=27），抗 Jo-1 和抗 SS-A/Ro52 抗体双阴性（26/27，96%）。与聚类 1 和聚类 2 相比，聚类 3 中复发患者的比例明显较低（风险比，0.37；95%置信区间，0.17-0.83；P=0.026 和风险比，0.42；95%置信区间，0.20-0.89；P=0.019）。聚类 1 和聚类 2 之间复发患者的比例没有差异。