A longitudinal cohort study of the anti-synthetase syndrome

Increased severity of interstitial lung disease in black patients and patients with anti-PL7 and anti-PL12 autoantibodies

Iago Pinal-Fernandez, Maria Casal-Dominguez, Julio A. Huapaya, Jemima Albayda, Julie J. Paik, Cheilonda Johnson, Leann Silhan, Lisa Christopher-Stine, Andrew L. Mammen, Sonye K. Danoff

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective. The aim was to study the prevalence, rate of appearance and severity of clinical features in patients with different anti-synthetase syndrome (ASyS) autoantibodies. Methods. All Johns Hopkins Myositis Longitudinal Cohort subjects positive for any ASyS autoantibodies were included. Clinical information, including symptoms, signs, strength, creatine kinase concentrations and pulmonary function tests, were prospectively collected. The standardized mortality and cancer rates and the rate of appearance and intensity of the different organ manifestations were assessed using univariate and multivariate analysis and compared between ASyS autoantibodies. Results. One hundred and twenty-four (73.4%) patients were positive for anti-Jo1, 23 (13.6%) for anti-PL12, 16 for anti-PL7 (9.5%) and 3 (1.8%) for anti-EJ or anti-OJ, respectively. The mean length of follow-up was 4.1 years. Anti-PL12 was more frequent in black subjects. Anti-PL12 and anti-PL7 were associated with more prevalent and severe lung involvement, often without muscle involvement. Anti-Jo1 displayed more severe muscle involvement compared with anti-PL12 patients. Concurrent anti-Ro52 was more prevalent in anti-Jo1 patients and was associated with earlier development of mechanic's hands, DM-specific skin findings and arthritis. Independent of ASyS antibody status, black patients demonstrated more severe lung involvement than white patients. There was no significant increase in mortality or cancer risk in ASyS patients compared with the general US population. Conclusion. Different ASyS autoantibodies are associated with phenotypically distinct subgroups within the ASyS spectrum. Anti-PL7 and anti-PL12 are characterized by more severe lung involvement, whereas anti-Jo1 is associated with more severe muscle involvement. Black race is a major prognostic factor associated with lung disease severity.

Original languageEnglish (US)
Article numberkex021
Pages (from-to)999-1007
Number of pages9
JournalRheumatology (United Kingdom)
Volume56
Issue number6
DOIs
StatePublished - Jun 1 2017

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Interstitial Lung Diseases
Ligases
Autoantibodies
Longitudinal Studies
Cohort Studies
Muscles
Lung
Myositis
Mortality
Respiratory Function Tests
Creatine Kinase
Lung Diseases
Signs and Symptoms
Arthritis
Neoplasms
Multivariate Analysis
Hand
Cross-Sectional Studies
Skin
Antibodies

Keywords

  • Anti-Ro52
  • Anti-synthetase antibodies
  • Anti-synthetase syndrome
  • Cohort study
  • Dermatomyositis
  • Myositis
  • Polymyositis
  • Prognostic factors

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

A longitudinal cohort study of the anti-synthetase syndrome : Increased severity of interstitial lung disease in black patients and patients with anti-PL7 and anti-PL12 autoantibodies. / Pinal-Fernandez, Iago; Casal-Dominguez, Maria; Huapaya, Julio A.; Albayda, Jemima; Paik, Julie J.; Johnson, Cheilonda; Silhan, Leann; Christopher-Stine, Lisa; Mammen, Andrew L.; Danoff, Sonye K.

In: Rheumatology (United Kingdom), Vol. 56, No. 6, kex021, 01.06.2017, p. 999-1007.

Research output: Contribution to journalArticle

Pinal-Fernandez, I, Casal-Dominguez, M, Huapaya, JA, Albayda, J, Paik, JJ, Johnson, C, Silhan, L, Christopher-Stine, L, Mammen, AL & Danoff, SK 2017, 'A longitudinal cohort study of the anti-synthetase syndrome: Increased severity of interstitial lung disease in black patients and patients with anti-PL7 and anti-PL12 autoantibodies', Rheumatology (United Kingdom), vol. 56, no. 6, kex021, pp. 999-1007. https://doi.org/10.1093/rheumatology/kex021
Pinal-Fernandez, Iago ; Casal-Dominguez, Maria ; Huapaya, Julio A. ; Albayda, Jemima ; Paik, Julie J. ; Johnson, Cheilonda ; Silhan, Leann ; Christopher-Stine, Lisa ; Mammen, Andrew L. ; Danoff, Sonye K. / A longitudinal cohort study of the anti-synthetase syndrome : Increased severity of interstitial lung disease in black patients and patients with anti-PL7 and anti-PL12 autoantibodies. In: Rheumatology (United Kingdom). 2017 ; Vol. 56, No. 6. pp. 999-1007.
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abstract = "Objective. The aim was to study the prevalence, rate of appearance and severity of clinical features in patients with different anti-synthetase syndrome (ASyS) autoantibodies. Methods. All Johns Hopkins Myositis Longitudinal Cohort subjects positive for any ASyS autoantibodies were included. Clinical information, including symptoms, signs, strength, creatine kinase concentrations and pulmonary function tests, were prospectively collected. The standardized mortality and cancer rates and the rate of appearance and intensity of the different organ manifestations were assessed using univariate and multivariate analysis and compared between ASyS autoantibodies. Results. One hundred and twenty-four (73.4{\%}) patients were positive for anti-Jo1, 23 (13.6{\%}) for anti-PL12, 16 for anti-PL7 (9.5{\%}) and 3 (1.8{\%}) for anti-EJ or anti-OJ, respectively. The mean length of follow-up was 4.1 years. Anti-PL12 was more frequent in black subjects. Anti-PL12 and anti-PL7 were associated with more prevalent and severe lung involvement, often without muscle involvement. Anti-Jo1 displayed more severe muscle involvement compared with anti-PL12 patients. Concurrent anti-Ro52 was more prevalent in anti-Jo1 patients and was associated with earlier development of mechanic's hands, DM-specific skin findings and arthritis. Independent of ASyS antibody status, black patients demonstrated more severe lung involvement than white patients. There was no significant increase in mortality or cancer risk in ASyS patients compared with the general US population. Conclusion. Different ASyS autoantibodies are associated with phenotypically distinct subgroups within the ASyS spectrum. Anti-PL7 and anti-PL12 are characterized by more severe lung involvement, whereas anti-Jo1 is associated with more severe muscle involvement. Black race is a major prognostic factor associated with lung disease severity.",
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AU - Casal-Dominguez, Maria

AU - Huapaya, Julio A.

AU - Albayda, Jemima

AU - Paik, Julie J.

AU - Johnson, Cheilonda

AU - Silhan, Leann

AU - Christopher-Stine, Lisa

AU - Mammen, Andrew L.

AU - Danoff, Sonye K.

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N2 - Objective. The aim was to study the prevalence, rate of appearance and severity of clinical features in patients with different anti-synthetase syndrome (ASyS) autoantibodies. Methods. All Johns Hopkins Myositis Longitudinal Cohort subjects positive for any ASyS autoantibodies were included. Clinical information, including symptoms, signs, strength, creatine kinase concentrations and pulmonary function tests, were prospectively collected. The standardized mortality and cancer rates and the rate of appearance and intensity of the different organ manifestations were assessed using univariate and multivariate analysis and compared between ASyS autoantibodies. Results. One hundred and twenty-four (73.4%) patients were positive for anti-Jo1, 23 (13.6%) for anti-PL12, 16 for anti-PL7 (9.5%) and 3 (1.8%) for anti-EJ or anti-OJ, respectively. The mean length of follow-up was 4.1 years. Anti-PL12 was more frequent in black subjects. Anti-PL12 and anti-PL7 were associated with more prevalent and severe lung involvement, often without muscle involvement. Anti-Jo1 displayed more severe muscle involvement compared with anti-PL12 patients. Concurrent anti-Ro52 was more prevalent in anti-Jo1 patients and was associated with earlier development of mechanic's hands, DM-specific skin findings and arthritis. Independent of ASyS antibody status, black patients demonstrated more severe lung involvement than white patients. There was no significant increase in mortality or cancer risk in ASyS patients compared with the general US population. Conclusion. Different ASyS autoantibodies are associated with phenotypically distinct subgroups within the ASyS spectrum. Anti-PL7 and anti-PL12 are characterized by more severe lung involvement, whereas anti-Jo1 is associated with more severe muscle involvement. Black race is a major prognostic factor associated with lung disease severity.

AB - Objective. The aim was to study the prevalence, rate of appearance and severity of clinical features in patients with different anti-synthetase syndrome (ASyS) autoantibodies. Methods. All Johns Hopkins Myositis Longitudinal Cohort subjects positive for any ASyS autoantibodies were included. Clinical information, including symptoms, signs, strength, creatine kinase concentrations and pulmonary function tests, were prospectively collected. The standardized mortality and cancer rates and the rate of appearance and intensity of the different organ manifestations were assessed using univariate and multivariate analysis and compared between ASyS autoantibodies. Results. One hundred and twenty-four (73.4%) patients were positive for anti-Jo1, 23 (13.6%) for anti-PL12, 16 for anti-PL7 (9.5%) and 3 (1.8%) for anti-EJ or anti-OJ, respectively. The mean length of follow-up was 4.1 years. Anti-PL12 was more frequent in black subjects. Anti-PL12 and anti-PL7 were associated with more prevalent and severe lung involvement, often without muscle involvement. Anti-Jo1 displayed more severe muscle involvement compared with anti-PL12 patients. Concurrent anti-Ro52 was more prevalent in anti-Jo1 patients and was associated with earlier development of mechanic's hands, DM-specific skin findings and arthritis. Independent of ASyS antibody status, black patients demonstrated more severe lung involvement than white patients. There was no significant increase in mortality or cancer risk in ASyS patients compared with the general US population. Conclusion. Different ASyS autoantibodies are associated with phenotypically distinct subgroups within the ASyS spectrum. Anti-PL7 and anti-PL12 are characterized by more severe lung involvement, whereas anti-Jo1 is associated with more severe muscle involvement. Black race is a major prognostic factor associated with lung disease severity.

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KW - Anti-synthetase syndrome

KW - Cohort study

KW - Dermatomyositis

KW - Myositis

KW - Polymyositis

KW - Prognostic factors

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