Background/Purpose: Arthritis is observed frequently in patients with anti-aminoacyl transfer RNA synthetase (ARS) autoantibodies and is usually not destructive like rheumatoid arthritis (RA). Despite several case reports with anti-ARS antibodies and with deforming arthritis, there is a controversy as to whether this is associated with anti-ARS antibody itself or concomitant RA. Moreover, previous reports focusing on articular involvement have been limited to anti-Jo-1 antibody, and it is still unclear whether arthropathies are common among anti-ARS antibodies. The aim of this study is to clarify the characteristics of arthropathies associated with anti-ARS antibody, focusing on structural damage and autoantibody profiles.

Methods: Fifty-six patients with anti-ARS antibodies were enrolled in this study from consecutive patients who visited Keio University Hospital between1983 and 2011, based on joint symptoms and availability of hand X-rays. Their clinical characteristics, anti-cyclic citrullinated peptide (anti-CCP) antibody, rheumatoid factor (RF), and hand X-ray findings were retrospectively examined.

Results: The anti-ARS specificities in 56 patients enrolled included Jo-1 in 28, EJ in 9, OJ in 1, PL-7 in 7, PL-12 in 5, and KS in 6. At the time of X-ray evaluation, the mean age was 57.6 years and the mean disease duration from onset of joint symptoms was 9.4 years. RF and anti-CCP antibody were positive in 25 (45 %) and 16 (29 %), respectively. Significant X-ray changes were found in 20 patients (36%). According to the patterns of X-ray findings garnered with cluster analysis, the patients were divided into two groups; Group A of 12 patients (21%) mainly with erosions and ankylosis, and Group B of 8 (14%) with the subluxations and periarticular calcinosis. When we compared the characteristics of these two groups, Group A showed the significantly higher rates of positive RF and anti-CCP with any anti-ARS specificities than Group B (83% versus 38%, and 75% versus 13%, respectively), consistent with the serologic features of RA. In contrast, all patients in group B were positive for anti-Jo-1 antibody independent of RF or anti-CCP.

Conclusion: Autoantibody profiles, including RF, anti-CCP, and individual anti-ARS specificity, are useful in classifying anti-ARS-associated arthropathies into a comorbid RA and a peculiar anti-Jo-1-related arthropathy.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/distinct-arthropaties-in-patients-with-anti-aminoacyl-trna-synthetase-antibodies-utility-of-autoantibody-profiles-in-discrimination/