Literature DB >> 29229096

Clinical characteristics of patients with anti-aminoacyl-tRNA synthetase antibody positive idiopathic interstitial pneumonia.

Hirokazu Yura1, Noriho Sakamoto2, Minoru Satoh3, Hiroshi Ishimoto1, Tetsuya Hanaka4, Chiyo Ito4, Tomoko Hasegawa3, Shin Tanaka5, Takuto Miyamura1, Shota Nakashima1, Atsuko Hara1, Tomoyuki Kakugawa1, Keishi Oda4, Takashi Kido4, Yasushi Obase1, Yuji Ishimatsu6, Kazuhiro Yatera4, Atsushi Kawakami7, Hiroshi Mukae1.   

Abstract

BACKGROUND: Anti-aminoacyl-tRNA synthetase (ARS) antibodies have been detected in patients with polymyositis/dermatomyositis (PM/DM) and are especially correlated with interstitial lung disease (ILD). The aim of this study was to clarify the clinical features of patients with anti-ARS antibody positive idiopathic interstitial pneumonias (IIPs).
METHODS: Patients were classified into three groups: 1) IIP with anti-ARS antibodies (ARS(+)IIP), 2) IIP without anti-ARS antibodies (ARS(-)IIP), and 3) PM/DM-associated ILD with anti-ARS antibodies (ARS(+)PM/DM-ILD). Clinical characteristics were compared retrospectively between the ARS(+)IIP group and the ARS(-)IIP group or ARS(+)PM/DM-ILD group.
RESULTS: Eighteen ARS(+)IIP, 284 ARS(-)IIP, and 20 ARS(+)PM/DM-ILD patients were enrolled. The ARS(+)IIP group was significantly older and the male sex was predominant, had a lower prevalence of signs of connective tissue disease, differences in HRCT findings and patterns, and higher KL-6 levels compared to the ARS(+)PM/DM-ILD group. The findings in the bronchoalveolar lavage fluid (BALF) showing lymphocytosis and a lower CD4/CD8 ratio were similar between the two groups. However, the ARS(+)IIP group had significantly lower percentage of sputum, higher prevalence of mechanic's hand, higher KL-6 levels, lower percentage of vital capacity in the pulmonary function test, and lower CD4/CD8 ratio in BALF, compared to the ARS(-)IIP group.
CONCLUSIONS: The present study demonstrated that features of pulmonary involvement were similar to those in the ARS(+)PM/DM-ILD group; however, some differences including HRCT findings and higher KL-6 levels suggest that ARS(+)IIP has severe ILD compared with ARS(+)PM/DM-ILD. Further prospective studies with a larger number of patients will elucidate the exact role of anti-ARS antibodies in IIPs.
Copyright © 2017 Elsevier Ltd. All rights reserved.

Entities:  

Keywords:  Anti-synthetase syndrome; Dermatomyositis; Idiopathic interstitial pneumonia; Polymyositis

Mesh:

Substances:

Year:  2017        PMID: 29229096     DOI: 10.1016/j.rmed.2017.10.020

Source DB:  PubMed          Journal:  Respir Med        ISSN: 0954-6111            Impact factor:   3.415


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