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Ro52/SSA 抗体在特发性炎性肌病中的临床特征和预后价值。

Clinical Characteristics and Prognostic Value of Ro52/SSA Antibodies in Idiopathic Inflammatory Myopathies.

机构信息

From the Department of Medicine, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA.

Rheumatology Service, Walter Reed National Military Medical Center, Bethesda, MD.

出版信息

J Clin Rheumatol. 2023 Oct 1;29(7):347-353. doi: 10.1097/RHU.0000000000002015.

Abstract

BACKGROUND/PURPOSE: Anti-Ro52 are myositis-associated antibodies found in idiopathic inflammatory myopathies (IIMs). This chart review aims to evaluate the frequency, significance, and associated clinical characteristics of Ro52/SSA positivity in IIM patients.

METHODS

We performed a chart review of IIM patients diagnosed between January 2006 and December 2020. All patients met either the 1975 Bohan and Peter or the European League Against Rheumatism/American College of Rheumatology classification criteria for probable or definite myositis. Demographics, clinical and serologic parameters, treatments, and outcomes were compared in patients with anti-Ro52/SSA antibodies and patients without anti-Ro52/SSA antibodies.

RESULTS

One hundred eighty-nine patients with IIM were tested for either Ro52 or SSA, with 45 positive for Ro52/SSA (23.8%). Patients with IIM and Ro52/SSA+ were younger at age at onset of disease (44.8 vs. 51.2 years, p = 0.008). Ro52/SSA+ was more common in antisynthetase syndrome (p < 0.001; odds ratio [OR], 4.44; 95% confidence interval [CI], 2.11-9.33) and not frequently identified in clinically amyopathic dermatomyositis (CADM) (p = 0.02; OR, 0.13; 95% CI, 0.02-0.96) or immune-mediated necrotizing myopathy (p = 0.003; OR, 0.14; 95% CI, 0.03-0.63). Of the extraskeletal muscle manifestations, interstitial lung disease (ILD) was strongly associated with Ro52/SSA+ (p < 0.001; OR, 6.61; 95% CI, 3.15-13.86), as was dysphagia (p = 0.006; OR, 2.73; 95% CI, 1.31-5.71). Interstitial lung disease pattern and pulmonary function testing impairment did not differ based on antibody status. There was no significant difference in outcomes between groups.

CONCLUSION

In this myositis cohort, Ro52/SSA+ was present in nearly one-fourth of the population and had a strong association with the antisynthetase syndrome subtype, ILD, and dysphagia. Although these disease manifestations are associated with significant morbidity, in our cohort, they were not associated with increased mortality or more severe ILD.

摘要

背景/目的:抗 Ro52 是自身免疫性炎性肌病(IIM)中发现的肌炎相关抗体。本图表回顾旨在评估 Ro52/SSA 阳性在 IIM 患者中的频率、意义和相关临床特征。

方法

我们对 2006 年 1 月至 2020 年 12 月期间诊断的 IIM 患者进行了图表回顾。所有患者均符合 1975 年 Bohan 和 Peter 或欧洲抗风湿病联盟/美国风湿病学会的可能或明确肌炎的分类标准。在抗 Ro52/SSA 抗体患者和无抗 Ro52/SSA 抗体患者中比较了人口统计学、临床和血清学参数、治疗和结局。

结果

189 名 IIM 患者接受了 Ro52 或 SSA 检测,其中 45 名 Ro52/SSA 阳性(23.8%)。Ro52/SSA+的 IIM 患者发病年龄较轻(44.8 岁 vs. 51.2 岁,p=0.008)。Ro52/SSA+在抗合成酶综合征中更为常见(p<0.001;比值比[OR],4.44;95%置信区间[CI],2.11-9.33),在临床无肌病性皮肌炎(CADM)中不常见(p=0.02;OR,0.13;95%CI,0.02-0.96)或免疫介导的坏死性肌病(p=0.003;OR,0.14;95%CI,0.03-0.63)。在骨骼外肌肉表现中,间质性肺病(ILD)与 Ro52/SSA+强烈相关(p<0.001;OR,6.61;95%CI,3.15-13.86),吞咽困难也是如此(p=0.006;OR,2.73;95%CI,1.31-5.71)。ILD 模式和肺功能检查损害不因抗体状态而异。两组之间的结果无显著差异。

结论

在本肌炎队列中,Ro52/SSA+ 存在于近四分之一的人群中,与抗合成酶综合征亚型、ILD 和吞咽困难密切相关。尽管这些疾病表现与显著的发病率相关,但在我们的队列中,它们与死亡率增加或更严重的ILD 无关。

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