Circulating Autoantibody Profiles as Predictive Signatures for Acute Exacerbation and Survival in Myositis-Associated Interstitial Lung Disease
- May 24
- 2 min read
Research Paper | 2026 | Volume 1 | Issue 01 | Page 42-46
Dr. Mohammad Samim Kuresi Khan Department of Respiratory Medicine, Dubai Medical College, UAE
ABSTRACT
BACKGROUND: Myositis-associated interstitial lung disease (MA-ILD) is a highly heterogeneous and aggressive condition characterized by unpredictable clinical trajectories. While myositis-specific antibodies (MSAs) are established diagnostic markers, their role as dynamic, predictive signatures for acute exacerbation (AE-ILD) and long-term mortality remains poorly defined. This study aims to identify circulating autoantibody profiles that serve as prognostic predictors for disease progression and survival in MA-ILD patients. METHODS: In this prospective cohort study, 120 patients with newly diagnosed MA-ILD were enrolled. Serum samples were collected at baseline and analyzed for a comprehensive panel of autoantibodies, including anti-MDA5, anti-Jo-1, anti-PL-7, anti-PL-13, anti-EJ, anti-OJ, anti-Ro52, and anti-SRP using line-blot assays and immunoprecipitation. Clinical endpoints included the development of AE-ILD and all-cause mortality over a 24-month follow-up period. Cox proportional hazard models and receiver operating characteristic (ROC) curves were utilized to determine the predictive accuracy of autoantibody signatures. RESULTS: High titers of anti-MDA5 and anti-Ro52 were identified as independent predictors of AE-ILD (Hazard Ratio [HR] 3.25; 95% CI 1.84–5.72, p < 0.001). Furthermore, the coexistence of anti-MDA5 and anti-Ro52 autoantibodies formed a high-risk "signature" that correlated with rapid functional decline (forced vital capacity [FVC] < 50% predicted) and significantly higher 24-month mortality (p < 0.001). Conversely, the presence of anti-Jo-1 antibodies was associated with a more indolent course and better survival outcomes. Multivariate analysis confirmed that the autoantibody profile, when integrated with baseline clinical severity scores, provided superior prognostic stratification compared to clinical variables alone. CONCLUSION: Circulating autoantibody profiles, particularly the co-occurrence of anti-MDA5 and anti-Ro52, are robust predictive signatures for acute exacerbation and poor survival in MA-ILD. These findings underscore the clinical utility of longitudinal autoantibody profiling for identifying high-risk patients who may benefit from early, aggressive immunomodulatory therapy. KEYWORDS: Myositis-Associated Interstitial Lung Disease, Autoantibodies, Anti-MDA5, Anti-Ro52, Acute Exacerbation, Prognosis, Survival Analysis.
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