Prognostic significance of anti-aminoacyl-tRNA synthetase antibodies in polymyositis/dermatomyositis-associated interstitial lung disease: a retrospective case control study

PLoS One. 2015 Mar 19;10(3):e0120313. doi: 10.1371/journal.pone.0120313. eCollection 2015.

Abstract

Background: In polymyositis/dermatomyositis (PM/DM), anti-aminoacyl-tRNA synthetase (ARS) antibodies are closely associated with interstitial lung disease (ILD), a frequent pulmonary complication. However, the clinical significance of anti-ARS antibodies is not well established.

Objective: We aimed to evaluate the clinical significance of anti-ARS antibodies in PM/DM-ILD patients.

Methods: Forty-eight consecutive PM/DM-ILD patients were studied retrospectively. Anti-ARS antibodies were screened by ELISA and confirmed by RNA immunoprecipitation test. Medical records, high-resolution computed tomography images, and surgical lung biopsy specimens were compared between ARS-positive (ARS group) and ARS-negative patients (non-ARS group).

Results: Anti-ARS antibodies were detected in 23 of 48 patients (48%). Radiologically, nonspecific interstitial pneumonia (NSIP) pattern was observed more frequently in the ARS group than in the non-ARS group (73.9% vs. 40%, P = 0.02). Pathologically, NSIP was the most frequent in both groups. Ten-year survival rate was also significantly higher in the ARS group than in the non-ARS group (91.6% vs. 58.7%, P = 0.02). Univariate Cox hazards analysis revealed that the presence of anti-ARS antibodies was associated with better prognosis (HR = 0.34, 95% CI 0.08-0.80; P = 0.01).

Conclusions: The presence of anti-ARS antibodies is a possible prognostic marker in patients with PM/DM-ILD.

MeSH terms

  • Adult
  • Aged
  • Amino Acyl-tRNA Synthetases / immunology
  • Autoantibodies / analysis*
  • Autoantibodies / immunology
  • Biomarkers / analysis
  • Case-Control Studies
  • Dermatomyositis / complications
  • Dermatomyositis / mortality
  • Dermatomyositis / pathology*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoprecipitation
  • Kaplan-Meier Estimate
  • Lung Diseases, Interstitial / complications
  • Lung Diseases, Interstitial / diagnosis*
  • Lung Diseases, Interstitial / mortality
  • Male
  • Middle Aged
  • Polymyositis / complications
  • Polymyositis / mortality
  • Polymyositis / pathology*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Autoantibodies
  • Biomarkers
  • Amino Acyl-tRNA Synthetases

Grants and funding

The authors received no specific funding for this work.