The Association of Anti-Aminoacyl-Transfer Ribonucleic Acid Synthetase Antibodies in Patients With Rheumatoid Arthritis and Interstitial Lung Disease

Abstract

Objectives:This study aims to analyze the distribution and clinicopathological characteristics of anti-aminoacyl-transfer ribonucleic acid (tRNA) synthetase (ARS) antibodies in rheumatoid arthritis patients. Patients and methods:We retrospectively studied the anti-ARS antibody levels in 228 RA patients' (44 males, 184 females; mean age 62.9±14.0 years; range 23 to 88 years) sera from their medical charts. We determined the association with anti-cyclic citrullinated peptide antibody levels, interstitial lung disease (ILD), rheumatoid factor, and methotrexate or biological disease modifying antirheumatic drug treatments. Results: Anti-ARS antibodies were detected in 14 RA patients (6.1%). ILD complications were significantly higher among anti-ARS antibody-positive patients (57.1% vs 22.4%, p<0.05). Levels of anti-threonyl-tRNA-synthetase (anti-PL-7) and anti-alanyl-tRNA-synthetase (anti-PL-12), two anti-ARS antibodies, were higher in RA patients with concurrent ILD (both p<0.05). Myositis and ILD worsening were not observed in three anti-ARS antibodypositive patients despite biological disease modifying antirheumatic drug administration. There was no difference in anti-cyclic citrullinated peptide and rheumatoid factor specificities between patients with or without ARS antibodies. Conclusion: Anti-ARS antibodies were detected in RA patients, with higher prevalence in patients with concurrent ILD. RA patients, specifically those with ILD complications, should be tested for anti-ARS antibodies.

Development of a New Classification System for Idiopathic Inflammatory Myopathies Based on Clinical Manifestations and Myositis-Specific Autoantibodies

“…Pathologic criteria were refined to isolate 2 new subgroups: inclusion body myositis (IBM) and immune-mediated necrotizing myopathy (IMNM) . Each approach defines overlapping entities; for instance, antisynthetase syndrome is classified as both DM or PM . A new classification system is beneficial to reduce confusion.…”

“…7 Each approach defines overlapping entities; for instance, antisynthetase syndrome is classified as both DM or PM. [8][9][10] A new classification system is beneficial to reduce confusion. Ideally, subgroups should share common characteristics in terms of phenotype, prognosis, and pathogenesis.…”

The clinical efficacy of traditional Chinese medicine in the treatment of rheumatoid arthritis with interstitial lung disease

“…More recently, women with seropositive RA have been shown to have a nearly 3-fold increased risk of mortality due to respiratory disease (including chronic obstructive pulmonary disease, asthma, pleurisy, lung abscess, bronchiectasis, and pulmonary fibrosis) compared to women without RA. [ 12 – 14 ]…”

Are These Truly Rheumatoid Arthritis or Antisynthetase Syndrome Cases?

“…In the study of Matsushida et al, 1 non-specific interstitial pneumonitis (NSIP) was reported as ILD type all over the ARS positive patients classified as RA. NSIP is the most common pattern of pulmonary involvement in patients with AS.…”

“…NSIP is the most common pattern of pulmonary involvement in patients with AS. 9 However, the most common pattern of pulmonary involvement that is expected to be seen in RA cases is usual interstitial pneumonia and it is not found as the most common form of pulmonary involvement in the relevant article of Matsushida et al 1 cases and etanercept in one case. Abatacept is a successfully tested agent in resistant myositis.…”