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Clinical characteristics of patients with anti-aminoacyl-tRNA synthetase antibody positive idiopathic interstitial pneumonia


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Title: Clinical characteristics of patients with anti-aminoacyl-tRNA synthetase antibody positive idiopathic interstitial pneumonia
Other Titles: 抗アミノアシルtRNA合成酵素抗体陽性特発性間質性肺炎患者の臨床的特徴
Authors: 由良, 博一
Authors (alternative): Yura, Hirokazu
Issue Date: 20-Mar-2018
Publisher: Elsevier Ltd.
Citation: Nagasaki University (長崎大学), 博士(医学) (2018-03-20)
Abstract: Background: Anti-aminoacyl-tRNA synthetase (ARS) antibodies have been detected in patients with polymyositis/dermatomyositis (PM/DM) and are especially correlated with interstitial lung disease (ILD). The aim of this study was to clarify the clinical features of patients with anti-ARS antibody positive idiopathic interstitial pneumonias (IIPs). Methods: Patients were classified into three groups: 1) IIP with anti-ARS antibodies (ARS(+)IIP), 2) IIP without anti-ARS antibodies (ARS(−)IIP), and 3) PM/DM-associated ILD with anti-ARS antibodies (ARS(+)PM/DM-ILD). Clinical characteristics were compared retrospectively between the ARS(+)IIP group and the ARS(−)IIP group or ARS(+)PM/DM-ILD group. Results: Eighteen ARS(+)IIP, 284 ARS(−)IIP, and 20 ARS(+)PM/DM-ILD patients were enrolled. The ARS(+)IIP group was significantly older and the male sex was predominant, had a lower prevalence of signs of connective tissue disease, differences in HRCT findings and patterns, and higher KL-6 levels compared to the ARS(+)PM/DM-ILD group. The findings in the bronchoalveolar lavage fluid (BALF) showing lymphocytosis and a lower CD4/CD8 ratio were similar between the two groups. However, the ARS(+)IIP group had significantly lower percentage of sputum, higher prevalence of mechanic's hand, higher KL-6 levels, lower percentage of vital capacity in the pulmonary function test, and lower CD4/CD8 ratio in BALF, compared to the ARS(−)IIP group. Conclusions: The present study demonstrated that features of pulmonary involvement were similar to those in the ARS(+)PM/DM-ILD group; however, some differences including HRCT findings and higher KL-6 levels suggest that ARS(+)IIP has severe ILD compared with ARS(+)PM/DM-ILD. Further prospective studies with a larger number of patients will elucidate the exact role of anti-ARS antibodies in IIPs.
Description: 長崎大学学位論文 学位記番号:博(医歯薬)甲第1043号 学位授与年月日:平成30年3月20日 / Author: Hirokazu Yura, Noriho Sakamoto, Minoru Satoh, Hiroshi Ishimoto, Tetsuya Hanaka, Chiyo Ito, Tomoko Hasegawa, Shin Tanaka, Takuto Miyamura, Shota Nakashima, Atsuko Hara, Tomoyuki Kakugawa, Keishi Oda, Takashi Kido, Yasushi Obase, Yuji Ishimatsu, Kazuhiro Yatera, Atsushi Kawakami, Hiroshi Mukae / Citation: Respiratory Medicine,132, pp189-194; 2017
Keywords: Anti-synthetase syndrome / Idiopathic interstitial pneumonia / Dermatomyositis / Polymyositis
URI: http://hdl.handle.net/10069/38322
ISSN: 09546111
DOI: 10.1016/j.rmed.2017.10.020
Relational Links: http://hdl.handle.net/10069/38085
Rights: © 2017 Elsevier Ltd. All rights reserved.
Type: Thesis or Dissertation
Text Version: ETD
Appears in Collections:dissertation

Citable URI : http://hdl.handle.net/10069/38322

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