A NEW study has identified distinct clinical and imaging patterns in patients with anti-synthetase syndrome-associated interstitial lung disease (ASS-ILD), revealing that the type of autoantibody plays a key role in disease presentation and may guide more tailored treatment approaches.
The study analysed 377 patients from two clinical centres, comparing those with the most common anti-synthetase antibody, anti-Jo-1, to those with other antibodies such as anti-EJ, anti-PL-7, and anti-PL-12.
Patients with non-Jo-1 antibodies were found to have longer delays to diagnosis, higher rates of hyperglobulinemia, and a greater likelihood of coexisting Sjögren’s syndrome. They were also more likely to show fibrotic lung patterns on imaging, particularly usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). In contrast, those with anti-Jo-1 antibodies more commonly exhibited an organising pneumonia pattern, which is generally considered more responsive to immunosuppressive therapy.
Treatment differences were also noted. Patients with anti-Jo-1 antibodies tended to receive higher doses of corticosteroids, although the use of antifibrotic therapies and overall mortality rates were similar between the groups.
The findings highlight how serological subtype influences not only clinical and radiographic presentation but also treatment decisions in ASS-ILD. The authors emphasised the importance of recognising these differences to support earlier diagnosis and more effective, individualised care.
“Patients with non-Jo-1 antibodies may be more prone to fibrotic lung disease and could benefit from earlier consideration of antifibrotic treatment,” the researchers concluded, adding that further long-term studies are needed to understand disease progression across antibody subtypes.
This research supports the growing movement in rheumatology and respiratory care toward precision medicine based on immunological profiling.
Reference
Zhou W et al. Clinical-imaging characteristics and management of anti-JO-1 and non-JO-1 anti-synthetase syndrome-associated interstitial lung disease. Rheumatology. 2025;DOI: 10.1093/rheumatology/keaf287.
