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Short-Term and Long-Term Outcome of Anti-Jo1-Positive Patients with Anti-Ro52 Antibody

https://doi.org/10.1016/j.semarthrit.2011.09.008Get rights and content

Objectives

The aims of the present study were to (1) assess clinical features and long-term outcome in anti-Jo1-positive patients with anti-Ro52 antibody; (2) compare characteristics of anti-Jo1-positive patients with and without anti-Ro52 antibody; and (3) compare features of anti-Ro52-positive patients with and without anti-Jo1 antibody.

Methods

The medical records of 89 consecutive anti-Jo1-positive patients with antisynthetase syndrome (ASS) were reviewed; 36 of these patients had coexistent anti-Ro52 antibody. Furthermore, the medical records of 13 consecutive anti-Ro52-positive patients without anti-Jo1 antibody were also reviewed.

Results

Nine anti-Jo1-positive patients (25%) with anti-Ro-52 antibody achieved remission of ASS, whereas 19 other patients (52.8%) improved and 8 patients (22.2%) worsened their clinical status. Anti-Jo1-positive patients with anti-Ro52 antibody experienced ASS-related complications: interstitial lung disease (n = 28), esophageal dysfunction (n = 9), and joint manifestations (n = 25), including periarticular hydroxyapatite calcifications and erosions of metacarpophalangeal and interphalangeal joints and wrists (n = 3); 7 anti-Ro52-positive patients (19.4%) had cancer. Anti-Jo1-positive patients with anti-Ro52 antibody, compared with those without, more commonly experienced deterioration of myositis and joint involvement, symptomatic form of ILD, and cancer; they also had decreased survival rate (P = 0.05). We further found that anti-Ro52-positive patients with anti-Jo1 antibody, compared with those without, were younger and more frequently exhibited ILD with poorer prognosis.

Conclusions

Our series underlines that the presence of anti-Ro52 antibody is associated with a particular phenotype of ASS, leading to more severe myositis and joint impairment. Moreover, the coexistence of anti-Ro52 antibody seems to be associated with an increased risk of cancer. We therefore suggest that anti-Jo1-positive patients should routinely undergo the search for anti-Ro52 antibody, as this autoantibody appears to impact patients' prognosis.

Section snippets

Patients and Methods

This retrospective study began with a search of the institutional centers' medical record index, which provides access to the diagnoses of the centers' patients. The first electronic search involved use of the codes PM and DM to identify patients with a diagnosis of PM/DM seen from January 1995 to January 2010 in 4 academic centers (Lille, Paris, Cochin, and Pitié-Salpêtrière Hospitals, Rouen). The diagnosis of PM/DM was based on the Bohan and Peter criteria (14, 15), as follows: (1) symmetric

General Characteristics of Anti-Jo1-Positive Patients with Anti-Ro52 Antibody

The 36 anti-Jo1-positive patients with anti-Ro52 antibody comprised 11 men and 25 women with a median age of 56 years [range: 20 to 75] at ASS diagnosis. Twenty-four patients had PM and 12 had DM. Thirty-two patients presented with myalgia (88.9%), and 27 exhibited muscle weakness (75%); the median score of muscle power at ASS diagnosis was 68 [range: 49 to 84]. The patients presented ASS-related complications: Raynaud's phenomenon (n = 18), mechanic's hands (n = 20), joint impairment (n = 25),

Discussion

The Ro/SSA antigen was first described in 1962 by Anderson and coworkers (27). It consists of 2 polypeptide components of 52 kDa and 60 kDa; Ro52 is biochemically and immunologically distinct from Ro60, Ro52 having the greatest immunogenicity (4). The Ro52 gene has been mapped to the end of the short arm of chromosome 11, and Ro52 antigen has been identified as a tripartite motif 21 protein (28). The expression of anti-Ro52 antibody is mainly associated with various connective tissue diseases,

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    The authors have no conflicts of interest to disclose.

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