Antinuclear antibodies and subclinical interstitial lung disease in community-dwelling adults: the MESA study

The presence of a systemic autoimmune rheumatic disease (ARD) is a well-known risk factor for interstitial lung disease (ILD). For example, 33% of adults with rheumatoid arthritis (RA) have subclinical ILD [1]. Higher serum levels of IgM rheumatoid factor (RF), IgA RF, and anti-cyclic citrullinated peptide antibody 2 are associated with subclinical ILD in community-dwelling adults [2]. It is unknown whether this relationship between autoimmunity and subclinical ILD is limited to RA-related autoantibodies, or extends more broadly to other epitopes. High attenuation areas (HAA) and interstitial lung abnormalities (ILA) are validated quantitative and qualitative subclinical ILD phenotypes, respectively. In community-dwelling adults, greater HAA is associated with reduced forced vital capacity, reduced exercise capacity, elevated serum levels of matrix metalloproteinase-7 and interleukin-6, higher prevalence of ILA on computed tomography (CT) scans of the chest, higher all-cause mortality rate, and an increased risk of developing clinically evident ILD and ILD-specific mortality at 12-year follow-up [3, 4]. ILA has been associated with all-cause mortality in four different longitudinal cohorts [5]. The purpose of this study was to examine the association between antinuclear antibody (ANA) and both HAA and ILA in community-dwelling adults enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA).

Source: European Respiratory Journal - April 15, 2020 Category: Respiratory Medicine Authors: Bernstein, E. J., Austin, J. H. M., Kawut, S. M., Raghu, G., Hoffman, E. A., Newell, J. D., Watts, J. R., Nath, P. H., Sonavane, S. K., Barr, R. G., Lederer, D. J. Tags: Original Articles: Research letters Source Type: research