北京大学学报（医学版）2023，Vol.55Issue(6)：958-965,8.DOI:10.19723/j.issn.1671-167X.2023.06.002
抗Jo-1抗体在特发性炎性肌病临床分层及疾病谱中的意义
Significance of anti-Jo-1 antibody's clinical stratification in idiopathic inflammatory myopathy and disease spectrum
摘要
Abstract
Objective:To investigate the significance of anti-histidyl tRNA synthetase(Jo-1)antibody in idiopathic inflammatory myopathies(IIM)and its diseases spectrum.Methods:We enrolled all the patients who were tested positive for anti-Jo-1 antibody by immunoblotting in Peking University People's Hospital between 2016 and 2022.And the patients diagnosed with anti-synthetase antibody syndrome(ASS)with negative serum anti-Jo-1 antibody were enrolled as controls.We analyzed the basic informa-tion,clinical characteristics,and various inflammatory and immunological indicators of the patients at the onset of illness.Results:A total of 165 patients with positive anti-Jo-1 antibody were enrolled in this study.Among them,80.5％were diagnosed with connective tissue disease.And 57.6％(95/165)were diagnosed with IIM,including ASS(84/165,50.9％),immune-mediated necrotizing myopathy(7/165,4.2％)and dermatomyositis(4/165,2.4％).There were 23.0％(38/165)diagnosed with other connective tissue disease,mainly including rheumatoid arthritis(11/165,6.7％),undifferentiated connective tissue disease(5/165,3.0％),interstitial pneumonia with autoimmune features(5/165,3.0％),undifferentiated arthritis(4/165,2.4％),Sjögren's syndrome(3/165,1.8％),systemic lu-pus erythematosus(3/165,1.8％),systemic vasculitis(3/165,1.8％),and so on.Other cases in-cluded 3(1.8％)malignant tumor patients,4(2.4％)infectious cases and so on.The diagnoses were not clear in 9.1％(15/165)of the cohort.In the analysis of ASS subgroups,the group with positive se-rum anti-Jo-1 antibody had a younger age of onset than those with negative serum anti-Jo-1 antibody(49.9 years vs.55.0 years,P=0.026).Clinical manifestations of arthritis(60.7％vs.33.3％,P=0.002)and myalgia(47.1％vs.22.2％,P=0.004)were more common in the ASS patients with posi-tive anti-Jo-1 antibody.With the increase of anti-Jo-1 antibody titer,the incidence of the manifestations of arthritis,mechanic hands,Gottron sign and Raynaud phenomenon increased,and the proportion of ab-normal creatine kinase and α-hydroxybutyric dehydrogenase index increased in the ASS patients.The in-cidence of myalgia and myasthenia were significantly more common in this cohort when anti-Jo-1 antibody-positive ASS patients were positive for one and more myositis specific antibodies/myositis associated autoantibodies(P＜0.05).Conclusion:The disease spectrum in patients with positive serum anti-Jo-1 antibody includes a variety of diseases,mainly ASS.And anti-Jo-1 antibody can also be found in many connective tissue diseases,malignant tumor,infection and so on.关键词
抗组氨酰tRNA合成酶抗体/抗合成酶综合征/结缔组织病Key words
Anti-histidyl tRNA synthetase antibody/Anti-synthetase syndrome/Connective tissue disease分类
医药卫生引用本文复制引用
李嘉辰,李玉慧,赖展鸿,邵苗,金月波,高小娟,张科,侯儆,张燕英,栗占国..抗Jo-1抗体在特发性炎性肌病临床分层及疾病谱中的意义[J].北京大学学报（医学版）,2023,55(6):958-965,8.基金项目
国家自然科学基金(82371804)、北京市自然科学基金海淀原始创新联合基金项目(L222017)、北京大学人民医院研究与发展基金(RDX2023-03)Supported by the National Natural Science Foundation of China(82371804),Beijing Natural-Science Foundation(L222017),Peking University People's Hospital Research and Development Foundation(RDX2023-03) （82371804）
