EN PL
ORIGINAL PAPER
The clinical phenotype associated with antisynthetase autoantibodies
 
More details
Hide details
1
Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
 
2
Department of Clinical Immunology and Transplantation, Medical University of Gdansk, Gdansk, Poland
 
 
Submission date: 2020-01-15
 
 
Final revision date: 2020-02-02
 
 
Acceptance date: 2020-02-10
 
 
Online publication date: 2020-02-28
 
 
Publication date: 2020-02-28
 
 
Reumatologia 2020;58(1):4-8
 
KEYWORDS
TOPICS
ABSTRACT
Objectives:
Specific systemic autoimmune syndrome characterized by inflammatory myopathy, arthritis or arthralgias, interstitial lung disease (ILD), fever, Raynaud’s phenomenon, and mechanic’s hands is called antisynthetase syndrome (AS). The aim of this study was to assess the clinical spectrum associated with presence of aminoacyl-transfer RNA synthetase autoantibodies (ASA).

Material and methods:
A total of 305 patients with presence of myositis-specific autoantibodies were identified in the database of immunological tests performed in the Clinical Immunology and Transplantology Unit, Medical University of Gdansk between January 2011 and March 2016. In 110 patients (36%) ASA were detected. The detailed analysis included 50 patients with ASA for whom full clinical data were available.

Results:
The incidence of specific ASA in the analyzed group was: Jo-1 46% (23 patients), PL-12 32% (16 patients), PL-7 16% (8 patients), OJ 12% (6 patients), EJ 6% (3 patients). In 10% (5 patients) there was coexistence of at least one ASA, and in another 5 patients there was coexistence of ASA with other antibodies specific for myositis (MSA). In the analyzed group of patients 11 (22%) satisfied the Bohan and Peter criteria for dermatomyositis, 1 for polymyositis. In 5 patients (10%) based on clinical presentation and ASA presence the AS was recognized. Another 3 patients met the criteria of the overlap syndrome polymyositis respectively with systemic lupus, rheumatoid arthritis, and scleroderma. In 5 patients undifferentiated connective tissue disease was diagnosed, and 14 consecutive patients were diagnosed with other connective tissue diseases, while 12 patients did not receive a definitive diagnosis.

Conclusions:
The clinical presentation of patients with the presence of ASA is varied. Their presence indicates not only idiopathic inflammatory myopathies, but also non-specifically other disease entities. These patients require observation for the development of idiopathic inflammatory myopathy, and ILD.

 
REFERENCES (20)
1.
Lundberg IE, Tjarnlund A, Bottai M, et al. 2017 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Adult and Juvenile Idiopathic Inflammatory Myopathies and Their Major Subgroups. Arthritis Rheumatol 2017; 69: 2271-2282, DOI: 10.1002/art.40320.
 
2.
Leclair V, Lundberg IE. New Myositis Classification Criteria – What We Have Learned Since Bohan and Peter. Curr Rheumatol Rep 2018; 20: 18, DOI: 10.1007/s11926-018-0726-4.
 
3.
Lega JC, Fabien N, Reynaud Q, et al. The clinical phenotype associated with myositis-specific and associated autoantibodies: A meta-analysis revisiting the so-called antisynthetase syndrome. Autoimm Rev 2014; 13: 883-891, DOI: 10.1016/j.autrev.2014.03.004.
 
4.
Fernandez C, Bardin N, De Paula AM, et al. Correlation of clinicoserologic and pathologic classifications of inflammatory myopathies: study of 178 cases and guidelines for diagnosis. Medicine (Baltimore) 2013; 92: 15-24, DOI: 10.1097/MD.0b013e31827ebba1.
 
5.
Mariampillai K, Granger B, Amelin D, et al. Development of a New Classification System for Idiopathic Inflammatory Myopathies Based on Clinical Manifestations and Myositis-Specific Autoantibodies. JAMA Neurol 2018; 75: 1528-1537, DOI: 10.1001/jamaneurol.2018.2598.
 
6.
Targoff IN. Laboratory testing in the diagnosis and management of idiopathic inflammatory myopathies. Rheum Dis Clin North Am 2002; 28: 859-890, DOI: 10.1016/s0889-857x(02)00032-7.
 
7.
Katzap E, Barilla-LaBarca ML, Marder G. Antisynthetase Syndrome. Curr Rheumatol Rep 2011; 13: 175-181, DOI: 10.1007/s11926-011-0176-8.
 
8.
Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med 1975; 292: 344-347, DOI:10.1056/NEJM197502132920706. Polymyositis and dermatomyositis (second of two parts). N Engl J Med 1975; 292: 403-407, DOI:10.1056/NEJM197502202920807.
 
9.
Cruellas MG, Viana Vdos S, Levy-Neto M, et al. Myositis-specific and myositis-associated autoantibody profiles and their clinical associations in a large series of patients with polymyositis and dermatomyositis. Clinics (Sao Paulo) 2013; 68: 909-914, DOI: 10.6061/clinics/2013(07)04.
 
10.
Ghirardello A, Borella E, Beggio M, et al. Myositis autoantibodies and clinical phenotypes. Auto Immun Highlights 2014; 5: 69-75, DOI: 10.1007/s13317-014-0060-4.
 
11.
Aggarwal R, Cassidy E, Fertig N, et al. Patients with non-Jo-1 anti-tRNA synthetase autoantibodies have worse survival than Jo-1 positive patients. Ann Rheum Dis 2014; 73: 227-232, DOI: 10.1136/annrheumdis-2012-201800.
 
12.
Hamaguchi Y, Fujimoto M, Matsushita T, et al. Common and distinct clinical features in adult patients with anti-aminoacyl-tRNA synthetase antibodies: heterogeneity within the syndrome. PLoS One 2013; 8: e60442, DOI: 10.1371/journal.pone.0060442.
 
13.
Hervier B, Devilliers H, Stanciu R, et al. Hierarchical cluster and survival analyses of antisynthetase syndrome: phenotype and outcome are correlated with anti-tRNA synthetase antibody specificity. Autoimmun Rev 2012; 12: 210-217, doi: 10.1016/j.autrev.2012.06.006. Epub 2012 Jul 5.
 
14.
Hirakata M, Suwa A, Takada T, et al. Clinical and immunogenetic features of patients with autoantibodies to asparaginyl-transfer RNA synthetase. Arthritis Rheum 2007; 56: 1295-1303, DOI: 10.10002/art.22506.
 
15.
Matsushita T, Hasegawa M, Fujimoto M, et al. Clinical evaluation of anti-aminoacyl-tRNA synthetase antibodies in Jap-anese patients with dermatomyositis. J Rheumatol 2007; 34: 1012-1018.
 
16.
Sato S, Kuwana M, Hirakata M. Clinical characteristics of Japanese patients with anti-OJ (anti-isoleucyl-tRNA synthetase) autoantibodies. Rheumatology (Oxford) 2007; 46: 842-845, DOI: 10.1093/rheumatology/kel435.
 
17.
Kalluri M, Sahn SA, Oddis CV, et al. Clinical profile of anti-PL-12 autoantibody. Cohort study and review of the literature. Chest 2009; 135: 1550-1556, DOI: 10.1378/chest.08-2233.
 
18.
Noguchi E, Uruha A, Suzuki S, et al. Skeletal Muscle Involvement in Antisynthetase Syndrome. JAMA Neurol 2017; 74: 992-999, DOI: 10.1001/jamaneurol.2017.0934.
 
19.
Yoshifuji H, Fujii T, Kobayashi S, et al. Anti-aminoacyl-tRNA synthetase antibodies in clinical course prediction of interstitial lung disease complicated with idiopathic inflammatory myopathies. Autoimmunity 2006; 39: 233-241, DOI: 10.1080/08916930600622884.
 
20.
Hozumi H, Enomoto N, Kono M, et al. Prognostic significance of anti-aminoacyl-tRNA Synthetase Antibodies in Polymyositis/Dermatomyositis-Associated interstitial Lung Disease: a Retrospective Case Control Study. PLoS One 2015; 10: e0120313, DOI: 10.1371/journal.pone.0120313.
 
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
eISSN:2084-9834
ISSN:0034-6233
Journals System - logo
Scroll to top