No 8, 2012

Publication of the Month

 

August 08/12: 

Clinical associations of anti-Ro52 antibodies

  

Key message:

  • Ro52 antibodies show clinical associations to distinct disease manifestations in antisynthetase syndrome (ASS) and systemic sclerosis (SSc).
  • Routine determination of anti-Ro52 is important for the efficient diagnosis and prognosis of ASS and SSc patients.

Background: SS-A/Ro antibodies have been described in many autoimmune diseases. They are differentiated into anti-Ro52 and anti-Ro60. The clinical significance of anti-Ro60 is already well described but that of anti-Ro52 remains still unclear. The following studies aim to better understand the clinical associations and manifestations of anti-Ro52 positive patients. 

 

 

Marie I, Hatron PY, Dominique S, Cherin P, Mouthon L, Menard JF; Levesque H, Jouen F
Short-Term and Long-Term Outcome of Anti-Jo1-Positive Patients with Anti-Ro52 Antibody
Semin Arthritis Rheum 2012;41:890-899

 

Summary: Anti-Jo-1 antibodies are most common in antisynthetase syndrome (ASS), a type of polymyositis with additional systemic complications. ASS patients positive for anti-Jo-1 and anti-Ro52 more commonly experienced deterioration of myositis and joint involvement, symptomatic form of interstitial lung disease (ILD), and cancer compared to those negative for Ro52 antibodies. The patients were younger, showed more frequently exhibited ILD with poorer prognosis and a decreased survival rate.

 

Conclusions: As the presence of anti-Ro52 appears to impact the prognosis of anti-Jo1-positive patients, the diagnosis of antisynthetase syndrome should routinely prompt the search for Ro52 antibodies, as the presence of anti-Ro52 appears to impact prognosis of anti-Jo1 positive patients.    

 

 

Hudson M, Pope J, Mahler M, Tatibouet S, Steele R, Baron M, Fritzler MJ
Clinical significance of antibodies to Ro52/TRIM21 in systemic sclerosis
Arthritis Res Ther 2012;14:R50 

Summary: In systemic sclerosis (SSc) the major SSc-related antibodies, such as anti-centromere, anti-topoisomerase I, anti-RNA polymerase III, and anti-Pm/Scl seem to be mutually exclusive. Nevertheless, Ro52 antibodies overlap with all major antibodies and are detected in 20% of SSc patients. Ro52 antibodies in SSc patients are strongly associated with interstitial lung disease and overlap syndrome.  

 

Conclusions: Anti-Ro52 were the second most common autoantibodies in the SSc cohort investigated and are associated with distinct disease manifestations in SSc. Therefore the determination anti-Ro52 in SSc may be of both diagnostic and prognostic importance.  

 

Comment: It is getting more and more obvious that anti-Ro52 and anti-Ro60 are different antibodies with different associations to autoimmune diseases and their manifestations. This diverging clinical significance makes a separate determination of both antibodies necessary to enable a clear diagnosis and prognosis on disease course resulting in a better treatment and patient management. This is supported by the availability of separate anti-Ro52 and anti-Ro60 EliA assays.

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As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.