Clinical evaluation of anti-aminoacyl tRNA synthetase antibodies in Japanese patients with dermatomyositis

• Published in: Journal of rheumatology 2007-05, Vol.34 (5), p.1012-1018
• Main Authors: MATSUSHITA, Takashi, HASEGAWA, Minoru, SAITO, Yuki, MATSUSHITA, Yukiyo, KAWARA, Shigeru, YASUI, Masahide, SEISHIMA, Mariko, OZAKI, Shoichi, KUWANA, Masataka, OGAWA, Fumihide, SATO, Shinichi, TAKEHARA, Kazuhiko, FUJIMOTO, Manabu, HAMAGUCHI, Yasuhito, KOMURA, Kazuhiro, HIRANO, Takashi, HORIKAWA, Mayuka, KONDO, Miki, ORITO, Hidemitsu, KAJI, Kenzo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Amino Acyl-tRNA Synthetases - immunology; Asian Continental Ancestry Group; Autoantibodies - blood; Autoimmune Diseases - complications; Autoimmune Diseases - immunology; Autoimmune Diseases - pathology; Biological and medical sciences; Dermatomyositis - complications; Dermatomyositis - immunology; Dermatomyositis - pathology; Diseases of striated muscles. Neuromuscular diseases; Female; Fluorescent Antibody Technique, Indirect; Hospitals, University; Humans; Lung Diseases, Interstitial - complications; Lung Diseases, Interstitial - immunology; Lung Diseases, Interstitial - pathology; Male; Medical sciences; Middle Aged; Neurology; Pneumology; Respiratory Function Tests; Respiratory system : syndromes and miscellaneous diseases; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
• ISSN: 0315-162X; 1499-2752

OBJECTIVE: To investigate the distribution of anti-aminoacyl-tRNA synthetase (anti-ARS) antibodies among patients with autoimmune diseases, and to analyze the clinical features of patients with dermatomyositis (DM) with anti-ARS antibodies. METHODS: Serum samples from 315 patients with autoimmune diseases or related disorders who had visited Kanazawa University Hospital or affiliated facilities were assessed for anti-ARS antibodies by immunoprecipitation. In particular, the association between anti-ARS antibodies and clinical features was investigated in detail in patients with DM. RESULTS: Anti-ARS antibody was positive in 16 (29%) of 55 patients with DM, 2 (22%) of 9 patients with polymyositis, and 7 (25%) of 28 patients with idiopathic pulmonary fibrosis. Although anti-ARS antibody was detected with high frequency (63%, 15/24) in DM patients with interstitital lung disease (ILD), the incidence of anti-ARS antibody was very low (3%, 1/31) in DM patients without ILD. Anti-ARS antibody-positive patients with DM had significantly higher incidences of ILD (94% vs 23%) and fever (64% vs 10%) than the antibody-negative patients. Some immunosuppressive agents, in addition to oral corticosteroids, were required more frequently in the antibody-positive patients with DM than the antibody-negative patients (88% vs 26%). Although 60% of DM patients with ILD simultaneously developed ILD and myositis, ILD preceded myositis in 33% of patients. CONCLUSION: Among patients with DM, anti-ARS antibodies are found in a subset with ILD. DM patients with anti-ARS antibodies appear to have a more persistent disease course that requires additional therapy compared to those without anti-ARS antibodies.