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Clinical and pathologic differences in interstitial lung disease based on antisynthetase antibody type.

Abstract：

BACKGROUND:Interstitial lung disease (ILD) is a common extramuscular manifestation of the idiopathic inflammatory myopathies (IIMs), dermatomyositis (DM) and polymyositis (PM). Patients with antisynthetase antibodies (ASA) demonstrate some or all of the features of the antisynthetase syndrome including IIM and ILD. It has been hypothesized that the clinical expression of antisynthetase syndrome varies between specific ASAs. OBJECTIVE:We sought to determine whether the myositis-associated ILD (MA-ILD) phenotype differs based on the presence of ASAs and by ASA subtype. METHODS:A cross-sectional and longitudinal analysis of consecutive patients enrolled at the Johns Hopkins Myositis Center with ILD in the setting of clinically diagnosed autoimmune myositis was conducted. RESULTS:Seventy-seven subjects were included; 36 were ASA negative, 28 were anti-Jo1 positive, and 13 were non-Jo1 ASA positive (5 anti-PL-12, 4 anti-PL-7, 2 anti-EJ, and 2 anti-OJ). Non-Jo1 ASA positive participants were more likely to be African-American than Caucasian as compared to both the anti-Jo1 positive (p = 0.01) and ASA negative groups (p < 0.01). ASA negative participants had better mean forced vital capacity percent predicted (FVC%) and total computed tomography scores over time compared to those with anti-Jo1 after controlling for potential confounders. CONCLUSIONS:ASA status was significantly different by race. Those with anti-Jo1 antibodies had worse lung function and CT scores over time compared to those without detectable antisynthetase antibodies. Further prospective study in a larger cohort is needed to determine whether these apparent antibody-specific differences in demographics and manifestations of disease translate into meaningful disparities in clinical outcomes.

journal_name

Respir Med

journal_title

Respiratory medicine

authors

Johnson C,Connors GR,Oaks J,Han S,Truong A,Richardson B,Lechtzin N,Mammen AL,Casciola-Rosen L,Christopher-Stine L,Danoff SK

doi

10.1016/j.rmed.2014.09.003

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

1542-8

issue

eissn

0954-6111

issn

1532-3064

pii

S0954-6111(14)00314-X

journal_volume

108

pub_type

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Clinical and pathologic differences in interstitial lung disease based on antisynthetase antibody type.