Anti-Ro52 autoantibodies are associated with interstitial lung disease and more severe disease in patients with juvenile myositis

Abstract

ObjectivesAnti-Ro52 autoantibodies are associated with more severe interstitial lung disease (ILD) in adult myositis patients with antiaminoacyl transfer (t)RNA synthetase autoantibodies. However, few studies have examined anti-Ro52 autoantibodies in juvenile myositis. The purpose of this study was to define the prevalence and clinical features associated with anti-Ro52 autoantibodies in a large cohort of patients with juvenile myositis.MethodsWe screened sera from 302 patients with juvenile dermatomyositis (JDM), 25 patients with juvenile polymyositis (JPM) and 44 patients with juvenile connective tissue disease–myositis overlap (JCTM) for anti-Ro52 autoantibodies by ELISA. Clinical characteristics were compared between myositis patients with and without anti-Ro52 autoantibodies.ResultsAnti-Ro52 autoantibodies were found in 14% patients with JDM, 12% with JPM and 18% with JCTM. Anti-Ro52 autoantibodies were more frequent in patients with antiaminoacyl tRNA synthetase (64%, p<0.001) and anti-MDA5 (31%, p<0.05) autoantibodies. After controlling for the presence of myositis-specific autoantibodies, anti-Ro52 autoantibodies were associated with the presence of ILD (36% vs 4%, p<0.001). Disease course was more frequently chronic, remission was less common, and an increased number of medications was received in anti-Ro52 positive patients.ConclusionsAnti-Ro52 autoantibodies are present in 14% of patients with juvenile myositis and are strongly associated with anti-MDA5 and antiaminoacyl tRNA synthetase autoantibodies. In all patients with juvenile myositis, those with anti-Ro52 autoantibodies were more likely to have ILD. Furthermore, patients with anti-Ro52 autoantibodies have more severe disease and a poorer prognosis.

Clinical characteristics of anti-Ro52α and anti-Ro52β antibodies in dermatomyositis/polymyositis

“…Anti-Ro52 has been known to be associated with ILD and Raynaud's phenomenon, but some reports were controversial [1]. A juvenile myositis study showed that anti-Ro52 in DM/PM was frequently detected with anti-ARS and strongly associated with ILD in each MSA subgroup [9]. In our study, we found no greater prevalence of ILD complication with anti-Ro52-positive patients in each MSA subgroup ( Supplementary Table S1).…”

Comment on: ‘Anti-Ro52 autoantibodies are associated with interstitial lung disease and more severe disease in patients with juvenile myositis’ by Sabbaghet al

“…The results of the study by Sabbagh et al indicated that the positive rate of anti-Ro52 autoantibodies in patients with JCTM was higher than that in those with PM and DM. However, the positive rate is also highly heterogeneous among patients with different JCTM, varying from 0 (juvenile systemic sclerosis) to 29% (juvenile idiopathic arthritis) 1. Furthermore, in subgroup analyses of this study, there was a significant difference regarding the prevalence of ILD between patients with and without anti-Ro52 autoantibodies only in JDM group, but no difference in JPM or JCTM groups.…”

“…We read with great interest the article by Sabbagh et al 1 published in the Annals of the Rheumatic Diseases . We congratulate the authors for their accuracy and the exhaustive data presented, which clearly demonstrate the importance of anti-Ro52 autoantibodies in disease monitoring, management and prognosis in patients with juvenile myositis.…”

“…First, in this study,1 the patients with juvenile myositis including juvenile dermatomyositis (JDM), juvenile polymyositis (JPM) and juvenile connective tissue disease–myositis (JCTM) overlap are a highly heterogeneous population. In particular, JCTM added a great heterogeneity to the study population.…”

Interleukin-33/suppression of tumorigenicity 2 (IL-33/ST2) axis in idiopathic inflammatory myopathies and its association with laboratory and clinical parameters: a pilot study

“…We presented for the first time the association between anti-Ro52 antibodies and sST2 levels in patients with IIM. Anti-Ro52 is described as the most common myositis-associated antibody in adults with myositis, what corresponds [24]. Presence of anti-Ro antibodies in PM may be associated with conductive disturbances such as atrioventricular heart blocks and bundle branch blocks [25].…”