Anti-aminoacyl-tRNA synthetase antibodies in clinical course prediction of interstitial lung disease complicated with idiopathic inflammatory myopathies
Anti-aminoacyl-tRNA synthetase antibodies in clinical course prediction of interstitial lung disease complicated with idiopathic inflammatory myopathies
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DOI：
10.1080/08916930600622884
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发表时间：
2006-05-01
期刊：
影响因子：
3.5
通讯作者：
Mimori, T
中科院分区：
文献类型：
--
作者：
Yoshifuji, H;Fujii, T;Mimori, T
在多发性肌炎和皮肌炎（PM/DM）的治疗中，间质性肺病（ILD）并发症是一个重要的预后因素。据报道，抗氨酰-tRNA合成酶（ARS）的自身抗体与ILD密切相关。本研究的目的是检查抗ARS抗体与ILD临床病程之间的相关性。我们调查了41例PM/DM合并ILD。根据治疗前和治疗后2个月的呼吸道症状、影像学表现和肺功能的变化，确定ILD对皮质类固醇（CS）的反应。用RNA免疫沉淀法筛选抗ARS（抗Jo-1、PL-7、PL-12、EJ、OJ和KS）抗体。在将患者分层为ILD前型、同时型和肌病前型时，抗ARS抗体在ILD前型中显著频繁（p < 0.05）。在分层为抗ARS阳性和阴性组中，阳性组ILD对CS的反应显著更好（p < 0.05）。但阳性组ILD复发率明显高于阴性组（p < 0.01），两组2年肺功能随访（% VC和% DLCO）无差异。总之，抗ARS筛查可能有助于预测ILD前期患者的迟发性肌病，并预测PM/DM患者的ILD临床病程。
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.