University of Debrecen, Faculty of Medicine, Division of Clinical Immunology, Móricz Zs. krt. 22, 4032 Debrecen, Hungary.
University of Debrecen, Faculty of Medicine, Department of Laboratory Medicine, Nagyerdei krt. 98, 4032 Debrecen, Hungary.
Biomed Res Int. 2018 Oct 25;2018:6416378. doi: 10.1155/2018/6416378. eCollection 2018.
The aim of this study was to determine the clinical, serological, and genetic features of anti-Jo-1 positive antisynthetase patients followed by a Hungarian single centre to identify prognostic markers, which can predict disease phenotypes and disease progression. It was a retrospective study using clinical database of 49 anti-Jo-1 positive patients. 100% of patients exhibited myositis, 73% interstitial lung disease, 88% arthritis, 65% Raynaud's phenomenon, 43% fever, 33% mechanic's hand, and 12% dysphagia. We could detect significant correlation between anti-Jo-1 titer and the CK and CRP levels at disease onset and during disease course. HLA DRB1⁎03 positivity was present in 68.96% of patients, where the CK level at diagnosis was significantly lower compared to the HLA DRB1⁎03 negative patients. HLA DQA1⁎0501-DQB1⁎0201 haplotype was found in 58.62% of patients, but no significant correlation was found regarding any clinical or laboratory features. Higher CRP, ESR level, RF positivity, and the presence of fever or vasculitic skin lesions at the time of diagnosis indicated a higher steroid demand and the administration of higher number of immunosuppressants during the follow-up within anti-Jo-1 positive patients. The organ involvement of the disease was not different in HLA-DRB1⁎0301 positive or negative patients who were positive to the anti-Jo-1 antibody; however, initial CK level was lower in HLA-DRB1⁎0301 positive patients. Distinct laboratory and clinical parameters at diagnosis could be considered as prognostic markers.
本研究旨在确定接受匈牙利单一中心随访的抗 Jo-1 阳性抗合成酶患者的临床、血清学和遗传学特征,以确定可预测疾病表型和疾病进展的预后标志物。这是一项回顾性研究,使用了 49 名抗 Jo-1 阳性患者的临床数据库。100%的患者表现出肌炎,73%的患者出现间质性肺病,88%的患者出现关节炎,65%的患者出现雷诺现象,43%的患者出现发热,33%的患者出现技工手,12%的患者出现吞咽困难。我们可以检测到抗 Jo-1 滴度与疾病发病时和疾病过程中 CK 和 CRP 水平之间存在显著相关性。68.96%的患者存在 HLA DRB1⁎03 阳性,与 HLA DRB1⁎03 阴性患者相比,这些患者的 CK 水平在诊断时显著降低。58.62%的患者存在 HLA DQA1⁎0501-DQB1⁎0201 单倍型,但与任何临床或实验室特征均无显著相关性。较高的 CRP、ESR 水平、RF 阳性以及诊断时存在发热或血管炎皮肤损伤,表明抗 Jo-1 阳性患者在随访期间需要更高剂量的类固醇和更多免疫抑制剂的治疗。在 HLA-DRB1⁎0301 阳性或阴性的抗 Jo-1 抗体阳性患者中,疾病的器官受累没有差异;然而,HLA-DRB1⁎0301 阳性患者的初始 CK 水平较低。在诊断时的不同实验室和临床参数可作为预后标志物。
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