Anti-RNA binding protein positivity in idiopathic interstitial pneumonia

Rene S. Bermea, Ayodeji Adegunsoye, Justin Oldham, Iazsmin Ventura, Cathryn Lee, Jonathan H. Chung, Steven Montner, Imre Noth, Mary E. Strek, Rekha Vij

Research output: Contribution to journalArticle

Abstract

Introduction: Idiopathic interstitial pneumonias (IIP) are diffuse lung diseases whose cause is unknown and often present with features of autoimmunity despite not meeting criteria for a connective tissue disease (CTD). Recent studies suggest that anti-RNA binding protein (anti-RBP) antibodies, which include anti-SSA, anti-SSB, anti-Sm, and anti-RNP, play a role in the loss of immune tolerance and severity of pulmonary hypertension (PH) in CTDs. We hypothesized that anti-RBP positive (RBP+) subjects would have worse measures of lung function, radiographic findings, PH, and survival than anti-RBP negative (RBP-) subjects. Methods: Subjects with both IIP and serologies for review were identified retrospectively and stratified based on anti-RBP antibody seropositivity. Baseline cohort characteristics, pulmonary function tests (PFT), ambulatory oxygen requirement, radiographic characteristics, markers of PH, and transplant-free survival were compared between anti-RBP positive and negative groups. Results: Five hundred twenty patients with IIP were identified, of which ten percent (n = 53) were anti-RBP positive. RBP+ as compared to RBP- subjects had significantly worse PFTs as indicated by FEV1 (59.6 vs. 64.9, p = 0.046) and FVC (71.6 vs. 78.8, p = 0.018). There was a higher prevalence of radiographic honeycombing (49.1% vs. 38.3%, p = 0.006) and emphysema (22.6% vs. 5.1%, p < 0.001) in the RBP+ group despite no difference in smoking history. The Pulmonary Artery-Aorta ratio was also larger in the RBP+ group (0.93 vs. 0.88, p = 0.040). There was no difference in transplant-free survival between groups (log rank = 0.912). Conclusion: Anti-RBP+ IIP patients may have worse lung function, increased chest radiographic abnormalities, and PH compared with those without these antibodies.

Original languageEnglish (US)
Pages (from-to)23-27
Number of pages5
JournalRespiratory Medicine
Volume146
DOIs
StatePublished - Jan 1 2019

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Idiopathic Interstitial Pneumonias
RNA-Binding Proteins
Pulmonary Hypertension
Survival
Antibodies
Transplants
Lung
Immune Tolerance
Connective Tissue Diseases
Respiratory Function Tests
Emphysema
Serology
Autoimmunity
Pulmonary Artery
Lung Diseases
Aorta
Thorax
Smoking
History
Oxygen

Keywords

  • Anti-RNA binding protein antibodies
  • Idiopathic interstitial pneumonia
  • Interstitial lung disease

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Bermea, R. S., Adegunsoye, A., Oldham, J., Ventura, I., Lee, C., Chung, J. H., ... Vij, R. (2019). Anti-RNA binding protein positivity in idiopathic interstitial pneumonia. Respiratory Medicine, 146, 23-27. https://doi.org/10.1016/j.rmed.2018.11.015

Anti-RNA binding protein positivity in idiopathic interstitial pneumonia. / Bermea, Rene S.; Adegunsoye, Ayodeji; Oldham, Justin; Ventura, Iazsmin; Lee, Cathryn; Chung, Jonathan H.; Montner, Steven; Noth, Imre; Strek, Mary E.; Vij, Rekha.

In: Respiratory Medicine, Vol. 146, 01.01.2019, p. 23-27.

Research output: Contribution to journalArticle

Bermea, RS, Adegunsoye, A, Oldham, J, Ventura, I, Lee, C, Chung, JH, Montner, S, Noth, I, Strek, ME & Vij, R 2019, 'Anti-RNA binding protein positivity in idiopathic interstitial pneumonia' Respiratory Medicine, vol. 146, pp. 23-27. https://doi.org/10.1016/j.rmed.2018.11.015
Bermea, Rene S. ; Adegunsoye, Ayodeji ; Oldham, Justin ; Ventura, Iazsmin ; Lee, Cathryn ; Chung, Jonathan H. ; Montner, Steven ; Noth, Imre ; Strek, Mary E. ; Vij, Rekha. / Anti-RNA binding protein positivity in idiopathic interstitial pneumonia. In: Respiratory Medicine. 2019 ; Vol. 146. pp. 23-27.
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abstract = "Introduction: Idiopathic interstitial pneumonias (IIP) are diffuse lung diseases whose cause is unknown and often present with features of autoimmunity despite not meeting criteria for a connective tissue disease (CTD). Recent studies suggest that anti-RNA binding protein (anti-RBP) antibodies, which include anti-SSA, anti-SSB, anti-Sm, and anti-RNP, play a role in the loss of immune tolerance and severity of pulmonary hypertension (PH) in CTDs. We hypothesized that anti-RBP positive (RBP+) subjects would have worse measures of lung function, radiographic findings, PH, and survival than anti-RBP negative (RBP-) subjects. Methods: Subjects with both IIP and serologies for review were identified retrospectively and stratified based on anti-RBP antibody seropositivity. Baseline cohort characteristics, pulmonary function tests (PFT), ambulatory oxygen requirement, radiographic characteristics, markers of PH, and transplant-free survival were compared between anti-RBP positive and negative groups. Results: Five hundred twenty patients with IIP were identified, of which ten percent (n = 53) were anti-RBP positive. RBP+ as compared to RBP- subjects had significantly worse PFTs as indicated by FEV1 (59.6 vs. 64.9, p = 0.046) and FVC (71.6 vs. 78.8, p = 0.018). There was a higher prevalence of radiographic honeycombing (49.1{\%} vs. 38.3{\%}, p = 0.006) and emphysema (22.6{\%} vs. 5.1{\%}, p < 0.001) in the RBP+ group despite no difference in smoking history. The Pulmonary Artery-Aorta ratio was also larger in the RBP+ group (0.93 vs. 0.88, p = 0.040). There was no difference in transplant-free survival between groups (log rank = 0.912). Conclusion: Anti-RBP+ IIP patients may have worse lung function, increased chest radiographic abnormalities, and PH compared with those without these antibodies.",
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AU - Bermea, Rene S.

AU - Adegunsoye, Ayodeji

AU - Oldham, Justin

AU - Ventura, Iazsmin

AU - Lee, Cathryn

AU - Chung, Jonathan H.

AU - Montner, Steven

AU - Noth, Imre

AU - Strek, Mary E.

AU - Vij, Rekha

PY - 2019/1/1

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N2 - Introduction: Idiopathic interstitial pneumonias (IIP) are diffuse lung diseases whose cause is unknown and often present with features of autoimmunity despite not meeting criteria for a connective tissue disease (CTD). Recent studies suggest that anti-RNA binding protein (anti-RBP) antibodies, which include anti-SSA, anti-SSB, anti-Sm, and anti-RNP, play a role in the loss of immune tolerance and severity of pulmonary hypertension (PH) in CTDs. We hypothesized that anti-RBP positive (RBP+) subjects would have worse measures of lung function, radiographic findings, PH, and survival than anti-RBP negative (RBP-) subjects. Methods: Subjects with both IIP and serologies for review were identified retrospectively and stratified based on anti-RBP antibody seropositivity. Baseline cohort characteristics, pulmonary function tests (PFT), ambulatory oxygen requirement, radiographic characteristics, markers of PH, and transplant-free survival were compared between anti-RBP positive and negative groups. Results: Five hundred twenty patients with IIP were identified, of which ten percent (n = 53) were anti-RBP positive. RBP+ as compared to RBP- subjects had significantly worse PFTs as indicated by FEV1 (59.6 vs. 64.9, p = 0.046) and FVC (71.6 vs. 78.8, p = 0.018). There was a higher prevalence of radiographic honeycombing (49.1% vs. 38.3%, p = 0.006) and emphysema (22.6% vs. 5.1%, p < 0.001) in the RBP+ group despite no difference in smoking history. The Pulmonary Artery-Aorta ratio was also larger in the RBP+ group (0.93 vs. 0.88, p = 0.040). There was no difference in transplant-free survival between groups (log rank = 0.912). Conclusion: Anti-RBP+ IIP patients may have worse lung function, increased chest radiographic abnormalities, and PH compared with those without these antibodies.

AB - Introduction: Idiopathic interstitial pneumonias (IIP) are diffuse lung diseases whose cause is unknown and often present with features of autoimmunity despite not meeting criteria for a connective tissue disease (CTD). Recent studies suggest that anti-RNA binding protein (anti-RBP) antibodies, which include anti-SSA, anti-SSB, anti-Sm, and anti-RNP, play a role in the loss of immune tolerance and severity of pulmonary hypertension (PH) in CTDs. We hypothesized that anti-RBP positive (RBP+) subjects would have worse measures of lung function, radiographic findings, PH, and survival than anti-RBP negative (RBP-) subjects. Methods: Subjects with both IIP and serologies for review were identified retrospectively and stratified based on anti-RBP antibody seropositivity. Baseline cohort characteristics, pulmonary function tests (PFT), ambulatory oxygen requirement, radiographic characteristics, markers of PH, and transplant-free survival were compared between anti-RBP positive and negative groups. Results: Five hundred twenty patients with IIP were identified, of which ten percent (n = 53) were anti-RBP positive. RBP+ as compared to RBP- subjects had significantly worse PFTs as indicated by FEV1 (59.6 vs. 64.9, p = 0.046) and FVC (71.6 vs. 78.8, p = 0.018). There was a higher prevalence of radiographic honeycombing (49.1% vs. 38.3%, p = 0.006) and emphysema (22.6% vs. 5.1%, p < 0.001) in the RBP+ group despite no difference in smoking history. The Pulmonary Artery-Aorta ratio was also larger in the RBP+ group (0.93 vs. 0.88, p = 0.040). There was no difference in transplant-free survival between groups (log rank = 0.912). Conclusion: Anti-RBP+ IIP patients may have worse lung function, increased chest radiographic abnormalities, and PH compared with those without these antibodies.

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