To investigate the association of anti-Ro52 antibody with the clinical features and disease progression of anti-synthetase syndrome (ASS) associated interstitial lung disease (ILD).

Clinical data were obtained and reviewed from 90 patients with ASS-ILD. All patients were followed, and based on high-resolution computed tomography (HRCT) findings, they were divided into a disease progression group (n=23) and a stable group (n=67). According to serological results, the patients were further subdivided into an anti-Ro52 antibody positive group (n=76) and an anti-Ro52 antibody negative group (n=14). Clinical data were then compared between groups, and a Logistic regression model was used to analyze the risk factors affecting the progression of ASS-ILD.

Of the 90 ASS-ILD patients, 23 (25.6%) were in the progressive group and 67 (74.4%) in the stable group. The proprotion of patients with fever, baseline levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), troponin I (TnI), C-reaction protein (CRP), serum ferritin (sFe), and serum carbohydrate antigen 125 (CA125), as well as the positive rates of anti-Ro52 and anti-PL-7 antibodies and the proportion of patients with a high titer of anti-Ro52 antibody were significantly higher in the disease progression group than in the stable group (P＜0.05). Baseline forced vital capacity (FVC%) and diffusion capacity of carbonmonoxide (DLCO%) was significantly lower in the progression group, whereas the frequency of relapse and baseline glucocorticoid dose were significantly higher (P＜0.05). Multivariate logistic regression analysis identified fever, low baseline lung function, more relapses, and a high titer of anti-Ro52 antibody were risk factors for the progression of ASS-ILD (P＜0.05). Among the 90 patients, 76 (84.4%) were positive for anti-Ro52 antibodies, and 14 (15.6%) tested negative. Compared with the anti-Ro52 antibody-negative group, the positive group had a higher prevalence of Raynaud's phenomenon, a higher frequency of fever, elevated baseline levels of ESR, CRP, sFe, and CA125, and more frequent relapses (P＜0.05). In contrast, baseline FVC% and DLCO% were significantly lower in the anti-Ro52 antibody positive group (P＜0.05).

Fever, low baseline lung function, more relapses, and a high titer of anti-Ro52 antibody are risk factors for the progression of ASS-ILD. Patients with anti-Ro52 antibody positive ASS-ILD exhibit more pronounced inflammation and worse baseline lung function. Therefore, closer monitoring of inflammatory markers and pulmonary function should be implemented in this patient population.