Clinical significance and new detection system of autoantibodies in myositis with interstitial lung disease
Clinical significance and new detection system of autoantibodies in myositis with interstitial lung disease
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DOI：
10.1177/0961203316651748
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发表时间：
2016-07-01
期刊：
影响因子：
2.6
通讯作者：
Mimori, T.
中科院分区：
文献类型：
--
作者：
Nakashima, R.;Hosono, Y.;Mimori, T.
抗氨酰-tRNA合成酶(ARS)和抗黑色素瘤分化相关基因5(MDA5)抗体与多发性肌炎和皮肌炎的间质性肺疾病密切相关。抗ARS阳性患者出现共同的临床特征，称为抗合成酶综合征，并有共同的临床病程，他们对糖皮质激素的初始治疗反应良好，但当糖皮质激素逐渐减少时，疾病往往会复发。抗MDA5抗体与进展迅速的间质性肺病和预后不良有关，特别是在亚洲。因此，从疾病的早期阶段就需要对抗MDA5阳性的患者进行强化免疫抑制治疗。最近建立了检测抗ARS和抗MDA5抗体的新的酶联免疫吸附试验，被认为是有效和有用的。这些检测方法有望在日常工作中得到广泛应用。
Anti-aminoacyl-tRNA synthetase (ARS) and anti-melanoma differentiation-associated gene 5 (MDA5) antibodies are closely associated with interstitial lung disease in polymyositis and dermatomyositis. Anti-ARS-positive patients develop common clinical characteristics termed anti-synthetase syndrome and share a common clinical course, in which they respond well to initial treatment with glucocorticoids but in which disease tends to recur when glucocorticoids are tapered. Anti-MDA5 antibody is associated with rapidly progressive interstitial lung disease and poor prognosis, particularly in Asia. Therefore, intensive immunosuppressive therapy is required for anti-MDA5-positive patients from the early phase of the disease. New enzyme-linked immunosorbent assays to detect anti-ARS and anti-MDA5 antibodies have recently been established and are suggested to be efficient and useful. These assays are expected to be widely applied in daily practice.