抗 Ro52 抗体与成人特发性炎性肌病相关间质性肺病的预后相关。
Anti-Ro52 antibodies are associated with the prognosis of adult idiopathic inflammatory myopathy-associated interstitial lung disease.
机构信息
Department of Respiratory Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing.
Department of Respiratory Medicine, Yixing People's Hospital, Affiliated Jiangsu University, Yixing.
出版信息
Rheumatology (Oxford). 2022 Nov 2;61(11):4570-4578. doi: 10.1093/rheumatology/keac090.
OBJECTIVES
In the present study, we aimed to assess the prevalence and clinical significance of anti-Ro52 antibodies in a cohort of patients with idiopathic inflammatory myopathy-associated interstitial lung disease (IIM-ILD) with different myositis-specific autoantibodies (MSAs).
METHODS
A cohort of 267 IIM-ILD patients, including 62 patients with PM, 126 patients with DM and 79 patients with clinically amyopathic DM (CADM) were retrospectively analysed in this study. Clinical and laboratory findings, pulmonary function tests (PFTs), HRCT patterns and treatment information were compared between patients with and without anti-Ro52 antibodies. The association between prognosis and anti-Ro52 antibodies was also evaluated based on different MSA subgroups.
RESULTS
Anti-Ro52 antibodies were more frequent in patients with anti-MDA5 (62.1%, P < 0.01) and anti-Jo1 (64.9%, P < 0.01) antibodies than in those with other MSAs. The proportion of patients with anti-Jo1 antibodies was higher in the anti-Ro52 antibody-positive group than in the anti-Ro52 antibody-negative group. Patients with anti-Ro52 antibodies were more likely to exhibit the Gottron sign than the anti-Ro52 antibody-negative group (P < 0.001). Furthermore, it was a predictive factor for rapid progression interstitial lung disease (RP-ILD) (P = 0.001) and was also associated with a higher mortality rate (log-rank test, P = 0.001). Furthermore, RP-ILD was more frequently exhibited in anti-MDA5- and anti-Ro52-positive patients. Moreover, anti-Ro52 antibody positivity was closely associated with a higher mortality rate in anti-MDA5-ILD patients (log-rank test, P < 0.05).
CONCLUSIONS
Anti-Ro52 antibodies were highly prevalent in patients with anti-MDA5 and anti-Jo1 antibodies. Within all patients with IIM-ILD, those with anti-Ro52 autoantibodies had a higher frequency of RP-ILD and a poorer prognosis, especially in the anti-MDA5 antibody subgroup.
目的
本研究旨在评估不同肌炎特异性自身抗体（MSA）的特发性炎性肌病相关间质性肺病（IIM-ILD）患者中抗 Ro52 抗体的流行率和临床意义。
方法
回顾性分析了 267 例 IIM-ILD 患者，包括 62 例皮肌炎（PM）患者、126 例多发性肌炎（DM）患者和 79 例临床无肌病性皮肌炎（CADM）患者。比较了抗 Ro52 抗体阳性和阴性患者的临床和实验室检查、肺功能检查（PFTs）、高分辨率计算机断层扫描（HRCT）表现和治疗信息。并根据不同 MSA 亚组评估了预后与抗 Ro52 抗体的关系。
结果
抗 MDA5（62.1%，P<0.01）和抗 Jo1（64.9%，P<0.01）抗体阳性患者的抗 Ro52 抗体阳性率高于其他 MSA 患者。抗 Ro52 抗体阳性组中抗 Jo1 抗体阳性患者的比例高于抗 Ro52 抗体阴性组。与抗 Ro52 抗体阴性组相比，抗 Ro52 抗体阳性患者更易出现 Gottron 征（P<0.001）。此外，它是快速进展性间质性肺病（RP-ILD）的预测因子（P=0.001），与更高的死亡率相关（对数秩检验，P=0.001）。此外，抗 MDA5 和抗 Ro52 阳性患者更常表现为 RP-ILD。此外，抗 Ro52 抗体阳性与抗 MDA5-ILD 患者的死亡率升高密切相关（对数秩检验，P<0.05）。
结论
抗 Ro52 抗体在抗 MDA5 和抗 Jo1 抗体阳性患者中高度流行。在所有 IIM-ILD 患者中，抗 Ro52 自身抗体阳性患者的 RP-ILD 发生率更高，预后更差，尤其是在抗 MDA5 抗体亚组中。
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