Anti-aminoacyl-tRNA synthetase antibodies in clinical course prediction of interstitial lung disease complicated with idiopathic inflammatory myopathies

Abstract

In the treatment of polymyositis and dermatomyositis (PM/DM), the complication of interstitial lung disease (ILD) is an important prognostic factor. It has been reported that autoantibodies against aminoacyl-tRNA synthetases (ARS) are strongly associated with ILD. The aim of this study is to examine the correlation between anti-ARS and the clinical course of ILD. We investigated 41 cases of PM/DM with ILD. The response of ILD to corticosteroids (CS) was determined according to the change in respiratory symptoms, image findings, and pulmonary function between, before and 2 months after the treatment. Anti-ARS (anti-Jo-1, PL-7, PL-12, EJ, OJ and KS) antibodies were screened with the RNA immunoprecipitation assay. In the stratification into ILD-preceding, simultaneous and myopathy-preceding types, anti-ARS antibodies were significantly frequent in the ILD-preceding type (p < 0.05). In the stratification into anti-ARS-positive and negative groups, the response of ILD to CS was significantly better in the positive group (p < 0.05). However, recurrence of ILD was significantly more frequent in the positive group (p < 0.01), and 2 year prognoses of pulmonary function (%VC and %DLCO) were not different between the two groups. In conclusion, screening of anti-ARS may be useful to predict late-onset myopathy in ILD-preceding patients and to predict the clinical course of ILD in PM/DM patients.

The pulmonary histopathologic manifestations of the anti-Jo-1 tRNA synthetase syndrome

“…5,8,10,11,13,17,19,21 Morbidity in both PM/DM and the anti-Jo-1 syndrome is related to acute respiratory decompensation at presentation and our study confirms this association and points out that the morphologic equivalent may be diffuse alveolar damage alone or acute lung injury superimposed on underlying fibrotic interstitial pneumonias such as usual interstitial pneumonia and fibrotic nonspecific interstitial pneumonia. 5,8,17,19,21 The limitations to this study are notable.…”

“…The most common of these is the antiJo-1 antisynthetase syndrome in which anti-histidyl tRNA synthetase (anti-Jo-1) antibodies are accompanied by clinical arthritis, Raynaud's phenomenon, myositis, mechanic's hands, and interstitial lung disease (ILD). [1][2][3][4][5][6][7][8][9][10] The anti-Jo-1 tRNA synthetase syndrome has a higher incidence of ILD, relative to classical PM/DM, approximating 90% in some series, and the presence of anti-Jo-1 antibodies correlates with poor patient prognosis. [11][12][13][14][15][16][17][18][19][20][21][22] In this report, we studied the pulmonary histopathologic changes of a select group of IIM patients with the anti-Jo-1 tRNA synthetase syndrome, generating the first and largest biopsy study focused on this specific group of patients.…”

Clinical and Pathological Findings of Interstitial Lung Disease Patients with Anti-Aminoacyl-tRNA Synthetase Autoantibodies

“…admission revealed GGO with peribronchovascular interstitial thickening and traction broncho-bronchioloectasis in 10 patients, and 5 also had consolidation ( (11,12), the same as our patient with PM and ILD. (15,18,19), 10% had anti-La/SS-B antibodies (18,19), and 10% had anti-RNP antibodies (19).…”

Síndrome antissintetase anti-Jo-1

“…4,31,33,34 Furthermore, positive anti-Jo-1 and/or interstitial pneumopathy as prognostic factors remain controversial. [34][35][36][37] In our patients, there was one death attributed to septic shock (hospital bronchopneumonia).…”