Naomi Yoshida1, Masaki Okamoto2, Shinjiro Kaieda3, Kiminori Fujimoto4, Tomohiro Ebata5, Morihiro Tajiri6, Masayuki Nakamura7, Masaki Tominaga8, Daisuke Wakasugi9, Tomotaka Kawayama10, Masataka Kuwana11, Tsuneyo Mimori12, Hiroaki Ida13, Tomoaki Hoshino14. 1. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: qu_up_fl_o_wer@yahoo.co.jp. 2. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: okamoto_masaki@med.kurume-u.ac.jp. 3. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: kaieda@med.kurume-u.ac.jp. 4. Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: kimichan@med.kurume-u.ac.jp. 5. Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: ebata_tomohiro@med.kurume-u.ac.jp. 6. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: motajiri@med.kurume-u.ac.jp. 7. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: nakamura@med.kurume-u.ac.jp. 8. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: tominaga_masaki@med.kurume-u.ac.jp. 9. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: wakasugi_daisuke@kurume-u.ac.jp. 10. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: kawayama_tomotaka@med.kurume-u.ac.jp. 11. Department of Rheumatology and Clinical Immunology, Nippon Medical School, Sendagi 1-1-5, Bunkyo-ku, Tokyo 113-0022, Japan. Electronic address: kuwanam@nms.ac.jp. 12. Department of Rheumatology and Clinical Immunology, Kyoto University, Yoshidahon-machi, Sakyo-ku, Kyoto 606-8501, Japan. Electronic address: mimorit@kuhp.kyoto-u.ac.jp. 13. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: ida@med.kurume-u.ac.jp. 14. Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Asahi-machi 77, Kurume, Fukuoka 830-0011, Japan. Electronic address: hoshino@med.kurume-u.ac.jp.
Abstract
BACKGROUND: We attempted to clarify whether the presence of anti-aminoacyl-transfer RNA synthetase antibody (anti-ARS Ab) or anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab) is associated with the therapeutic response of polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD). METHODS: We retrospectively investigated 22 patients with PM/DM-ILD (10 positive for anti-ARS Ab and nine positive for anti-MDA5 Ab) for whom antibody analysis of conserved serum was possible. We assessed mortality in the first three months as the therapeutic response in the acute phase and compared changes in clinical data for up to one year considered as the chronic phase. We classified the clinical changes over the year into three groups: Improvement (increased % vital capacity [%VC] or diffusing capacity of the lung for carbon monoxide [%DLCO]≥10 or 15%), deterioration (decreased %VC or %DLCO≥10 or 15%), and no change (remainder of the changes). The extent of abnormality demonstrated by high-resolution computed tomography (HRCT) was scored. RESULTS: Positivity for anti-MDA5 Ab, but not for anti-ARS Ab, was associated with mortality in the first 3 months. Evaluation of the therapeutic response in the first year showed that positivity for the anti-ARS Ab, but not for the anti-MDA5 Ab, was associated with an improvement in %DLCO and a decline in the serum KL-6 levels. Positivity for the anti-ARS Ab or negativity for anti-MDA5 Ab was associated with a greater decrease in bronchial dilatation as seen by HRCT. CONCLUSIONS: Anti-ARS and anti-MDA5 Abs are associated with the therapeutic response of PM/DM-ILD.
BACKGROUND: We attempted to clarify whether the presence of anti-aminoacyl-transfer RNA synthetase antibody (anti-ARS Ab) or anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab) is associated with the therapeutic response of polymyositis/dermatomyositis-associated interstitial lung disease (PM/DM-ILD). METHODS: We retrospectively investigated 22 patients with PM/DM-ILD (10 positive for anti-ARS Ab and nine positive for anti-MDA5 Ab) for whom antibody analysis of conserved serum was possible. We assessed mortality in the first three months as the therapeutic response in the acute phase and compared changes in clinical data for up to one year considered as the chronic phase. We classified the clinical changes over the year into three groups: Improvement (increased % vital capacity [%VC] or diffusing capacity of the lung for carbon monoxide [%DLCO]≥10 or 15%), deterioration (decreased %VC or %DLCO≥10 or 15%), and no change (remainder of the changes). The extent of abnormality demonstrated by high-resolution computed tomography (HRCT) was scored. RESULTS: Positivity for anti-MDA5 Ab, but not for anti-ARS Ab, was associated with mortality in the first 3 months. Evaluation of the therapeutic response in the first year showed that positivity for the anti-ARS Ab, but not for the anti-MDA5 Ab, was associated with an improvement in %DLCO and a decline in the serum KL-6 levels. Positivity for the anti-ARS Ab or negativity for anti-MDA5 Ab was associated with a greater decrease in bronchial dilatation as seen by HRCT. CONCLUSIONS: Anti-ARS and anti-MDA5 Abs are associated with the therapeutic response of PM/DM-ILD.