Long‐term risk of cancer development among anti‐Th/To antibody–positive systemic sclerosis patients: comment on the article by Mecoli et al

Anti-Th/To antibodies in systemic sclerosis: analysis of long-term follow-up of pulmonary involvement, organ damage accrual and mortality in an Italian cohort with a case-control study

“…Notably, none of our anti-Th/To+ patients died due to SSc-related causes, while cancer was the most frequent cause of death. An overall increased long-term incidence of cancer history in patients with anti-Th/To antibodies was reported by a small Japanese study (12), while anti-Th/To antibodies were associated with a reduced risk of cancer diagnosis within the first 3 years after SSc onset as compared with other SSc subsets in a larger American study (11). These results confirm that both time and autoantibodies are critical factors to consider when stratifying the risk of malignancies in SSc patients (11).…”

“…Thirdly, in an American cohort, anti-Th/To antibodies were associated with a reduced risk of cancer diagnosis within the first 3 years after SSc onset, as compared with other SSc subsets (11). On the contrary, others reported an overall high incidence of cancer history in Japanese patients with anti-Th/ To antibodies and raised the concern that it could explain higher mortality in this SSc subset (12). Therefore, the present study was focused on the analysis of long-term outcome of ILD, organ damage accrual, association with cancer, and mortality in Italian SSc patients with anti-Th/To autoantibodies, through a case-control study.…”

A case of anti-Th/To antibody-positive interstitial lung disease and pulmonary arterial hypertension that does not meet the classification criteria of systemic sclerosis: Comment on the article by Moschetti et al.

“…Since her serum showed a nucleolar pattern in indirect immunofluorescence studies, we suspected ATAs. Our in-house enzyme-linked immunosorbent assay using recombinant hPop1 and Rpp25 (6), which are major epitopes for ATAs, showed her serum to react to both. This study was approved by the ethics committees of Nagoya University Hospital and Ichinomiya Municipal Hospital, and conducted in accordance with the Declaration of Helsinki.…”

The need for international multicentre collaborative studies to better characterise the clinical profile of anti-Th/To-positive patients: reply to the comment by Sakaida et al.

“…We also underlined that, besides the association with PAH, many open questions regarding the clinical profile of anti-Th/To+ patients need to be addressed (1). These include, for example, the relationship with cancer: in previous literature both reduced frequency of cancer diagnosis within the first 3 years after SSc onset ( 5) and an overall increased long-term incidence of cancer in these patients (6) were reported. Furthermore, data concerning organ damage (7), which is linked to morbidity, mortality and reduction of patients' quality of life, are even more limited in anti-Th/To+ patients (1).…”