Associations between anti-Ro52 antibodies and lung fibrosis in mixed connective tissue disease

Gunnarsson, Ragnar; El-Hage, Fadi; Aaløkken, Trond Mogens; Reiseter, Silje; Lund, May Brit; Garen, Torhild; Molberg, Øyvind

doi:10.1093/rheumatology/kev300

Cited by 80 publications

(57 citation statements)

References 15 publications

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“…Association between positive anti-SS-A 52 and the presence of digital ulcers was not reported before in patients with SSc, although anti-SS-A 52 was previously reported to be associated with pulmonary fibrosis in patients with mixed connective tissue disorder (23). This issue requires a more detailed research.…”

Section: Discussionmentioning

confidence: 83%

An analysis of the relationship between autoantibodies andclinical findings in patients with systemic sclerosis

Yayla¹,

İlgen²,

Düzgün³

2018

Turk J Med Sci

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Background/aim: We aimed to investigate the prevalence of anti-RNA polymerase (RNAP) III and other autoantibodies in a group of Turkish patients with systemic sclerosis (SSc) and their relation with clinical features. Materials and methods:The prevalence of anti-RNAP III and other autoantibodies was analyzed in 93 patients with SSc and control groups including 86 patients with systemic lupus erythematosus (SLE) and 65 healthy subjects, respectively. Their relationship with diseases findings was assessed in a cross-sectional manner.Results: Prevalences of anti-RNAP III were 2/93 (2.2%) in SSc, 1/86 (1.2%) in SLE, and 1/65 (1.5%) in the healthy group and there was no difference among groups (P > 0.999). Anti-Sm was significantly more common in SLE patients (P < 0.001), whereas antitopoisomerase I and anticentromere protein B were significantly more common in SSc patients (P < 0.001). There was a significant association between antitopoisomerase I positivity and interstitial lung disease (P < 0.001), and interestingly there was also a significant association between anti-SS-A 52 positivity and the presence of digital ulcers in patients with SSc. Conclusion:Our data show that anti-RNAP III in SSc patients was low in frequency in a Turkish population.

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Section: Discussionmentioning

confidence: 83%

An analysis of the relationship between autoantibodies andclinical findings in patients with systemic sclerosis

Yayla¹,

İlgen²,

Düzgün³

2018

Turk J Med Sci

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“…These antibodies were associated with an odds ratio of 4.4 (1.8 to 10.3; P<0.002) for the presence of lung fibrosis. 55 A cluster analysis based on the clinical features of the 201 patients in the Hungarian cohort found increased mortality in patients with pulmonary hypertension compared with those with ILD. 53 Thus, lung involvement in MCTD is both common and associated with increased mortality.…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Management of interstitial lung disease associated with connective tissue disease

Mathai

Danoff

2016

BMJ

249

205

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The lung is a common site of complications of systemic connective tissue disease (CTD), and lung involvement can present in several ways. Interstitial lung disease (ILD) and pulmonary hypertension are the most common lung manifestations in CTD. Although it is generally thought that interstitial lung disease develops later on in CTD it is often the initial presentation ("lung dominant" CTD). ILD can be present in most types of CTD, including rheumatoid arthritis, scleroderma, systemic lupus erythematosus, polymyositis or dermatomyositis, Sjögren's syndrome, and mixed connective tissue disease. Despite similarities in clinical and pathologic presentation, the prognosis and treatment of CTD associated ILD (CTD-ILD) can differ greatly from that of other forms of ILD, such as idiopathic pulmonary fibrosis. Pulmonary hypertension (PH) can present as a primary vasculopathy in pulmonary arterial hypertension or in association with ILD (PH-ILD). Therefore, detailed history, physical examination, targeted serologic testing, and, occasionally, lung biopsy are needed to diagnose CTD-ILD, whereas both non-invasive and invasive assessments of pulmonary hemodynamics are needed to diagnose pulmonary hypertension. Immunosuppression is the mainstay of treatment for ILD, although data from randomized controlled trials (RCTs) to support specific treatments are lacking. Furthermore, treatment strategies vary according to the clinical situation-for example, the treatment of a patient newly diagnosed as having CTD-ILD differs from that of someone with an acute exacerbation of the disease. Immunosuppression is indicated only in select cases of pulmonary arterial hypertension related to CTD; more commonly, selective pulmonary vasodilators are used. For both diseases, comorbidities such as sleep disordered breathing, symptoms of dyspnea, and cough should be evaluated and treated. Lung transplantation should be considered in patients with advanced disease but is not always feasible because of other manifestations of CTD and comorbidities. Clinical trials of novel therapies including immunosuppressive therapies are needed to inform best treatment strategies.

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“…In PM/DM, anti-Jo-1 and anti-SSA/Ro antibodies have also been found to be linked with severe and extensive ILD [61]. In MCTD, anti-Ro52 have been associated with lung fibrosis [62]. …”

Section: Pulmonary ‘Disease Activity' In Monitoringmentioning

confidence: 99%

Monitoring of Lung Involvement in Rheumatologic Disease

Paschalaki

Jacob²,

Wells

2016

Respiration

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The monitoring of lung involvement in patients with connective tissue diseases is central to optimal long-term management and is directed towards: (a) the detection of supervening lung involvement not present at presentation and (b) the identification of disease progression in established lung disease. For both goals, accurate surveillance requires multi-disciplinary evaluation with the integration of symptomatic change, serial pulmonary function trends and imaging data. Evaluated in isolation, each of these monitoring domains has significant limitations. Symptomatic change may be confounded by a wide variety of systemic factors. Pulmonary function tests provide the most reliable data, but are limited by measurement variability, the heterogeneity of functional patterns and the confounding effects of non-pulmonary factors. Chest radiography is insensitive to change but may provide rapid confirmation of major disease progression or alert the clinician to respiratory co-morbidities. Although high-resolution computed tomography has a central role in assessing disease severity, it should be used very selectively as a monitoring tool due to the associated radiation burden. Ancillary tests include echocardiography and exercise testing to proactively identify cases of pulmonary hypertension and worsening of oxygenation. In summary, a multi-disciplinary approach is essential for the identification of disease progression and prompt treatment of comorbidities that severely impact on the morbidity and mortality of disease.

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Associations between anti-Ro52 antibodies and lung fibrosis in mixed connective tissue disease

Abstract: Our cross-sectional data suggest that anti-Ro52 antibodies may serve as a potential marker for lung fibrosis in MCTD.

Cited by 80 publications

References 15 publications

An analysis of the relationship between autoantibodies andclinical findings in patients with systemic sclerosis

An analysis of the relationship between autoantibodies andclinical findings in patients with systemic sclerosis

Management of interstitial lung disease associated with connective tissue disease

Monitoring of Lung Involvement in Rheumatologic Disease

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