Highlights
- •Anti-Ro52 antibodies were strongly associated with the prevalence of interstitial lung disease at the diagnosis of connective tissue disease, even after adjusting for the coexistence of anti-Ro60 antibodies.
- •Anti-Ro52 antibodies positivity should lead clinicians to careful screening of interstitial lung disease at the diagnosis of connective tissue disease.
- •Anti-Ro52 antibodies could represent a useful severity marker of connective tissue diseases.
Abstract
Objectives
Clinical significance of anti-Ro52 antibodies in connective tissue diseases (CTD)
is controversial. Anti-Ro52 antibodies might be associated with a more severe CTD
phenotype, especially interstitial lung disease (ILD). The aims of this study were
to evaluate ILD prevalence and severity, the prevalence of micro- or macroangiopathy
and CTD-associated cancers in CTD with anti-Ro52 antibodies.
Methods
CTD patients with anti-Ro52 antibody screening by immunoblot at diagnosis were enrolled.
Two groups were retrospectively formed according to the presence of anti-Ro52 antibodies
with an unbiased 1:1 matching on CTD types. Unsupervised multiple correspondence analysis
and hierarchical clustering analysis were used to aggregate anti-Ro52 positive patients
in subgroups.
Results
408 CTD patients were included. Anti-Ro52 antibodies were detected in 33 % of CTD
patients. Anti-Ro52 antibodies were associated with ILD at CTD diagnosis (47.8% vs. 23.0%, OR 3.3 95% IC 1.4 to 8.0, p = 0.008), even after adjusting for the presence of anti-Ro60 antibodies, especially
in patients with antisynthetase syndrome, primary Sjögren syndrome and systemic sclerosis.
Micro- or macroangiopathy was more frequent in anti-Ro52 positive CTD patients (18.6%
vs. 9.7%, p = 0.02) and CTD patients with anti-Ro52 antibodies experienced more frequent relapses
and required more immunosuppressive drugs. Clusters 4 and 5 identified anti-Ro52 positive
CTD patients with severe ILD and with clinical features of systemic sclerosis or antisynthetase
syndrome respectively.
Conclusions
We found that anti-Ro52 antibodies were independently associated with ILD in CTD patients
irrespective of CTD type. Anti-Ro52 antibodies could be associated with severity and
a more relapsing disease course in CTD patients.
Keywords
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Article info
Publication history
Published online: May 07, 2021
Accepted:
April 19,
2021
Received in revised form:
March 2,
2021
Received:
January 13,
2021
Identification
Copyright
© 2021 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
