Association between anti-PL7 antibodies and increased fibrotic component in patients with antisynthetase syndrome and interstitial lung disease: a cross-sectional study

• Published in: Clinical rheumatology Vol. 43; no. 6; pp. 1971 - 1978
• Main Authors: Rivero-Gallegos, Daphne, Mejía, Mayra, Rocha-González, Héctor I., Huerta-Cruz, Juan C., Falfán-Valencia, Ramcés, Ramos-Martínez, Espiridion, Mateos-Toledo, Heidegger N., Castillo-López, María F., Rodríguez-Torres, Yeimi K., Lira-Boussart, Valeria, Rojas-Serrano, Jorge
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-06-2024; Springer Nature B.V
• Subjects: Adult; Aged; Antibodies; Antibodies, Antinuclear - blood; Antibodies, Antinuclear - immunology; Autoantibodies; Autoantibodies - blood; Autoantibodies - immunology; Cross-Sectional Studies; Female; Fibrosis; Humans; Immunosuppressive agents; Inflammation; Lung diseases; Lung Diseases, Interstitial - complications; Lung Diseases, Interstitial - immunology; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Mortality; Myositis - complications; Myositis - immunology; Original Article; Pneumonia; Pulmonary fibrosis; Respiratory function; Respiratory Function Tests; Rheumatology; Anti-PL7; Myositis; Antisynthetase syndrome; Autoantibodies; Interstitial lung disease; Prognostic factors
• ISSN: 0770-3198; 1434-9949; 1434-9949
• DOI: 10.1007/s10067-024-06965-w

Objective
To evaluate whether anti-PL7 and anti-PL12 autoantibodies are associated with a greater extent of the fibrotic component of ILD in ASSD patients.
Methods
Patients with ILD-ASSD who were positive for one of the following autoantibodies: anti-Jo1, anti-PL7, anti-PL12, and anti-EJ were included. Clinical manifestations, CPK levels, pulmonary function tests, and HCRT assessments were prospectively collected according to the Goh index. The fibrotic, inflammatory, and overall extension of the Goh index and DL
CO
were assessed by multiple linear analyses and compared between ASSD antibody subgroups.
Results
Sixty-six patients were included; 17 were positive for anti-Jo1 (26%), 17 for anti-PL7 (26%), 20 for anti-PL12 (30%), and 9 (14%) for anti-EJ. Patients with anti-PL7 and anti-PL12 had a more extensive fibrotic component than anti-Jo1. Anti-PL7 patients had a 7.9% increase in the fibrotic extension (
cβ
 = 7.9; 95% CI 1.863, 13.918), and the strength of the association was not modified after controlling for sex, age, and time of disease evolution (
aβ
 = 7.9; 95% CI 0.677, 15.076) and also was associated with an increase in ILD severity after adjusting for the same variables, denoted by a lower DL
CO
(
aβ
 =  − 4.47; 95% CI − 8.919 to − 0.015).
Conclusions
Anti-PL7-positive ASSD patients had more extensive fibrosis and severe ILD than the anti-Jo1 subgroup. This information is clinically useful and has significant implications for managing these patients, suggesting the need for early consideration of concurrent immunosuppressive and antifibrotic therapy.