抗氨酰-tRNA合成酶抗体在多肌炎/皮肌炎相关间质性肺疾病中的预后意义：一项回顾性病例对照研究
Prognostic significance of anti-aminoacyl-tRNA synthetase antibodies in polymyositis/dermatomyositis-associated interstitial lung disease: a retrospective case control study.
作者信息
Hozumi Hironao, Enomoto Noriyuki, Kono Masato, Fujisawa Tomoyuki, Inui Naoki, Nakamura Yutaro, Sumikawa Hiromitsu, Johkoh Takeshi, Nakashima Ran, Imura Yoshitaka, Mimori Tsuneyo, Suda Takafumi
机构信息
Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
出版信息
PLoS One. 2015 Mar 19;10(3):e0120313. doi: 10.1371/journal.pone.0120313. eCollection 2015.
BACKGROUND
In polymyositis/dermatomyositis (PM/DM), anti-aminoacyl-tRNA synthetase (ARS) antibodies are closely associated with interstitial lung disease (ILD), a frequent pulmonary complication. However, the clinical significance of anti-ARS antibodies is not well established.
OBJECTIVE
We aimed to evaluate the clinical significance of anti-ARS antibodies in PM/DM-ILD patients.
METHODS
Forty-eight consecutive PM/DM-ILD patients were studied retrospectively. Anti-ARS antibodies were screened by ELISA and confirmed by RNA immunoprecipitation test. Medical records, high-resolution computed tomography images, and surgical lung biopsy specimens were compared between ARS-positive (ARS group) and ARS-negative patients (non-ARS group).
RESULTS
Anti-ARS antibodies were detected in 23 of 48 patients (48%). Radiologically, nonspecific interstitial pneumonia (NSIP) pattern was observed more frequently in the ARS group than in the non-ARS group (73.9% vs. 40%, P = 0.02). Pathologically, NSIP was the most frequent in both groups. Ten-year survival rate was also significantly higher in the ARS group than in the non-ARS group (91.6% vs. 58.7%, P = 0.02). Univariate Cox hazards analysis revealed that the presence of anti-ARS antibodies was associated with better prognosis (HR = 0.34, 95% CI 0.08-0.80; P = 0.01).
CONCLUSIONS
The presence of anti-ARS antibodies is a possible prognostic marker in patients with PM/DM-ILD.
背景
在多发性肌炎/皮肌炎（PM/DM）中，抗氨酰tRNA合成酶（ARS）抗体与间质性肺病（ILD）密切相关，ILD是一种常见的肺部并发症。然而，抗ARS抗体的临床意义尚未完全明确。
目的
我们旨在评估抗ARS抗体在PM/DM-ILD患者中的临床意义。
方法
对48例连续的PM/DM-ILD患者进行回顾性研究。通过酶联免疫吸附测定（ELISA）筛选抗ARS抗体，并通过RNA免疫沉淀试验进行确认。比较ARS阳性患者（ARS组）和ARS阴性患者（非ARS组）的病历、高分辨率计算机断层扫描图像和外科肺活检标本。
结果
48例患者中有23例（48%）检测到抗ARS抗体。在影像学上，ARS组比非ARS组更频繁地观察到非特异性间质性肺炎（NSIP）模式（73.9%对40%，P = 0.02）。在病理学上，NSIP在两组中都是最常见的。ARS组的10年生存率也显著高于非ARS组（91.6%对58.7%，P = 0.02）。单因素Cox风险分析显示，抗ARS抗体的存在与更好的预后相关（风险比[HR]=0.34，95%置信区间[CI]0.08-0.80；P = 0.01）。
结论
抗ARS抗体的存在可能是PM/DM-ILD患者的一个预后标志物。
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