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Clinical Evaluation of Anti-Aminoacyl tRNA Synthetase Antibodies in Japanese Patients with Dermatomyositis
TAKASHI MATSUSHITA, MINORU HASEGAWA, MANABU FUJIMOTO, YASUHITO HAMAGUCHI, KAZUHIRO KOMURA, TAKASHI HIRANO, MAYUKA HORIKAWA, MIKI KONDO, HIDEMITSU ORITO, KENZO KAJI, YUKI SAITO, YUKIYO MATSUSHITA, SHIGERU KAWARA, MASAHIDE YASUI, MARIKO SEISHIMA, SHOICHI OZAKI, MASATAKA KUWANA, FUMIHIDE OGAWA, SHINICHI SATO, and KAZUHIKO TAKEHARA ABSTRACT. Objective. To investigate the distribution of anti-aminoacyl-tRNA synthetase (anti-ARS) antibodies among patients with autoimmune diseases, and to analyze the clinical features of patients with dermatomyositis (DM) with anti-ARS antibodies. Methods. Serum samples from 315 patients with autoimmune diseases or related disorders who had visited Kanazawa University Hospital or affiliated facilities were assessed for anti-ARS antibodies by immunoprecipitation. In particular, the association between anti-ARS antibodies and clinical features was investigated in detail in patients with DM. Results. Anti-ARS antibody was positive in 16 (29%) of 55 patients with DM, 2 (22%) of 9 patients with polymyositis, and 7 (25%) of 28 patients with idiopathic pulmonary fibrosis. Although anti-ARS antibody was detected with high frequency (63%, 15/24) in DM patients with interstitital lung disease (ILD), the incidence of anti-ARS antibody was very low (3%, 1/31) in DM patients without ILD. Anti-ARS antibody-positive patients with DM had significantly higher incidences of ILD (94% vs 23%) and fever (64% vs 10%) than the antibody-negative patients. Some immunosuppressive agents, in addition to oral corticosteroids, were required more frequently in the antibody-positive patients with DM than the antibody-negative patients (88% vs 26%). Although 60% of DM patients with ILD simultaneously developed ILD and myositis, ILD preceded myositis in 33% of patients. Conclusion. Among patients with DM, anti-ARS antibodies are found in a subset with ILD. DM patients with anti-ARS antibodies appear to have a more persistent disease course that requires additional therapy compared to those without anti-ARS antibodies. (First Release Feb 15 2007; J Rheumatol 2007;34:1012–8) Key Indexing Terms:
ANTI-AMINOACYL tRNA SYNTHETASE ANTIBODY From the Department of Dermatology and Division of Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science; Department of Dermatology, National Hospital Organization Kanazawa Medical Center, Kanazawa; Department of Dermatology, Ogaki Municipal Hospital, Ogaki; Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki; Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo; and the Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. T. Matsushita, MD, PhD; M. Hasegawa, MD, PhD; M. Fujimoto, MD; Y. Hamaguchi, MD, PhD; K. Komura, MD, PhD; T. Hirano, MD; M. Horikawa, MD, PhD; M. Kondo, MD, PhD; H. Orito, MD; K. Kaji, MD; Y. Saito, MD; Y. Matsushita, MD, PhD; K. Takehara, MD, PhD, Professor, Chairman, Department of Dermatology, Kanazawa University Graduate School of Medical Science; S. Kawara, MD, PhD, Department of Dermatology, National Hospital Organization Kanazawa Medical Center; M. Yasui, MD, PhD, Division of Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science; M. Seishima, MD, PhD, Department of Dermatology, Ogaki Municipal Hospital; S. Ozaki, MD, PhD, Professor, Chairman, Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine; M. Kuwana, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine; F. Ogawa, MD, PhD; S. Sato, MD, PhD, Professor, Chairman, Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences. Address reprint requests to Dr. M. Hasegawa, Department of Dermatology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan. E-mail: minoruha@derma.m.kanazawa-u.ac.jp Accepted for publication January 8, 2007.
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