抗 Ro-52 抗体与特发性炎症性肌病患者间质性肺病发生的相关性。

Association of anti-Ro-52 antibodies with occurrence of interstitial lung disease in patients with idiopathic inflammatory myopathy.

机构信息

Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Sheng-Li Road, Tainan, 704, Taiwan.

Division of Chest Medicine, Department of Internal Medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No. 138, Sheng-Li Road, Tainan, 704, Taiwan.

出版信息

Arthritis Res Ther. 2024 Aug 22;26(1):152. doi: 10.1186/s13075-024-03382-x.

DOI:10.1186/s13075-024-03382-x

PMID:39175076

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11340136/

Abstract

BACKGROUND

Anti-Ro-52 antibodies have been associated with interstitial lung disease (ILD) in various autoimmune diseases. However, their role in ILD among patients with idiopathic inflammatory myopathies (IIMs) is relatively underexplored. This study aimed to investigate the association between anti-Ro-52 antibodies and the occurrence of ILD in individuals with IIMs.

METHODS

This retrospective observational study included 604 patients who underwent myositis autoantibody testing between July 2018 and January 2021 at our hospital and were diagnosed with either IIMs or IIM-mimics. Comparative analyses were conducted between IIMs and IIM-mimics, as well as within the IIM group between cases with and without ILD. Logistic regression or Firth's logistic regression analyses were employed to assess the risk of ILD development in different IIM subgroups and myositis antibody categories.

RESULTS

This study included 190 patients with IIM and 414 patients with IIM-mimics. Patients with IIM demonstrated higher incidence of ILD, concurrent autoimmune disease, and a greater likelihood of various myositis autoantibodies when compared to the IIM-mimics group. Within the IIM patient cohort, those with ILD exhibited a later age of onset of IIM, an increased mortality rate, and a more frequent presence of anti-aminoacyl-tRNA synthetase (ARS) antibodies compared to those without ILD. The presence of any myositis-specific antibody (MSA) was associated with a six-fold increased risk of ILD, while dual positivity for MSA and anti-Ro-52 antibodies conferred a twenty-fold risk. Anti-ARS antibodies carried a 14-fold increased risk of ILD, which escalated to 38-fold in cases of dual positivity for anti-ARS and anti-Ro-52 antibodies. Anti-Ro-52 antibodies alone increased the risk eight-fold.

CONCLUSIONS

Among patients with IIM, the presence of ILD was linked to higher mortality. Certain autoantibodies, notably anti-ARS and anti-Ro-52 antibodies, were associated with an increased risk of ILD. The greatest risk of ILD was observed in cases of dual positivity for anti-ARS and anti-Ro-52 antibodies.

摘要

背景

抗 Ro-52 抗体与各种自身免疫性疾病中的间质性肺病（ILD）有关。然而，它们在特发性炎性肌病（IIM）患者中的ILD 中的作用相对未被充分探索。本研究旨在调查抗 Ro-52 抗体与 IIM 患者发生 ILD 的相关性。

方法

这是一项回顾性观察性研究，纳入了 2018 年 7 月至 2021 年 1 月在我院进行肌炎自身抗体检测并诊断为 IIM 或 IIM 样疾病的 604 例患者。对 IIM 和 IIM 样疾病进行了比较分析，以及在 IIM 组中对有和无 ILD 的病例进行了比较分析。采用逻辑回归或 Firth 逻辑回归分析评估不同 IIM 亚组和肌炎抗体类别中ILD 发生的风险。

结果

本研究包括 190 例 IIM 患者和 414 例 IIM 样疾病患者。与 IIM 样疾病组相比，IIM 患者的 ILD 发生率更高，同时合并自身免疫性疾病的概率更高，并且更可能出现各种肌炎自身抗体。在 IIM 患者队列中，ILD 患者的 IIM 发病年龄较晚，死亡率较高，且更常出现抗氨酰-tRNA 合成酶（ARS）抗体。任何肌炎特异性抗体（MSA）的存在与 ILD 的发生风险增加 6 倍相关，而 MSA 和抗 Ro-52 抗体的双重阳性则使风险增加 20 倍。抗 ARS 抗体使 ILD 的发生风险增加 14 倍，而在同时存在抗 ARS 和抗 Ro-52 抗体的情况下则增加到 38 倍。单独存在抗 Ro-52 抗体时风险增加 8 倍。