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Colegio de Medicina Interna de México.

2022, Número 4

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Med Int Mex 2022; 38 (4)


Síndrome antisintetasa: diagnóstico, manifestaciones clínicas y tratamiento. La evidencia hasta ahora

Alemán-Fernández CG, Alagón-Fernández CP

Idioma: Español
Referencias bibliográficas: 45
Paginas: 840-846
Archivo PDF: 199.43 Kb.


RESUMEN

En 1992 se propuso por primera vez el concepto de síndrome antisintetasa, una enfermedad autoinmunitaria incluida entre las miopatías inflamatorias. Se caracteriza por enfermedad pulmonar intersticial, artritis no erosiva, miositis, síndrome de Raynaud, fiebre de origen desconocido y manos de mecánico. Hay 10 anticuerpos antisintetasa conocidos, el anti-Jo-1 es el más común. Desde 1975 se establecieron criterios para clasificar las miopatías inflamatorias, pero en 2010 Connors y su grupo publicaron los criterios para el diagnóstico del síndrome antisintetasa. En la actualidad deben cumplirse criterios específicos de anticuerpos, hallazgos clínicos y enfermedad muscular para el diagnóstico del síndrome antisintetasa, considerada una enfermedad diferente a la dermatomiositis y la polimiositis. Se ha informado que los hallazgos clínicos diferirán entre pacientes según el tipo de anticuerpo presente o positivo. No existe un consenso internacional ni ensayos con distribución al azar para el tratamiento de pacientes con síndrome antisintetasa, pero existen reportes de casos con resultados positivos en pacientes tratados con diferentes fármacos inmunomoduladores.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Marguerite C, Bunn C, Beynon H, Bernstein R, et al.Polymyositis, pulmonary fibrosis and autoantibodies toaminoacyl-tRNA synthetase enzimes. Q J Med 1990; 77:1019-1038. doi: 10.1093/qjmed/77.1.1019.

  2. Witt LJ, Curran JJ, Strek ME. The diagnosis and treatmentof antisynthetase syndrome. Clin Pulm Med 2016; 23: 218-226. doi: 10.1097/CPM.0000000000000171.

  3. Targoff IN. Autoantibodies in polymyositis. Rheum Dis ClinNorth Am 1992; 18 (2): 455-82.

  4. Mariampillai K, Granger B, Amelin D, Guiguet M, etal. Development of a new classification system foridiopathic inflammatory myopathies based on clinicalmanifestations and myositis-specific autoantibodies.JAMA Neurol 2018; 75 (12): 1528-1537. doi: 10.1001/jamaneurol.2018.2598.

  5. Shigeaki S, Akinori U, Norihiro S, Ichizo N. Integrateddiagnosis Project for inflammatory myopathies: an associationbetween autoantibodies and muscle pathology.Autoimmun Rev 2017; 16 (7): 693-700. doi: 10.1016/j.autrev.2017.05.003.

  6. Allenbach Y, Benveniste O, Goebel H-H, Stenzel W. Integratedclassification of inflammatory myopathies. NeuropatholAppl Neurobiol 2017; 43 (1): 62-81. doi: 10.1111/nan.12380.

  7. Connors GR, Christopher-Stine L, Oddis CV, Danoff S.Interstitial lung disease associated with the idopathicinflammatory myopathies: what progress has been madein the past 35 years? Chest 2010; 138: 1464-1474. doi:10.1378/chest.10-0180.

  8. Solomon J, Swigris JJ, Brown KK. Myositis-related interstitiallung disease and antisynthetase syndrome. JBras Pneumol 2011; 37: 100-109. doi: 10.1590/s1806-37132011000100015.

  9. Bohan A, Peter JB. Polymyositis and dermatomyositis.N Engl J Med 1975; 292: 344-347. doi: 10.1056/NEJM197502132920706.

  10. Bohan A, Peter JB. Polymyositis and dermatomyositis(second of two parts). N Engl J Med 1975; 292: 403-407.doi: 10.1056/NEJM197502202920807.

  11. Greco M, García de Yébenes MJ, Alarcón I, et al. AB0656Antisynthetase syndrome: clinical value of Solomo’s andConnor’s diagnosis criteria. Ann Rheum Dis 2019; 78: 1789.

  12. Cavagna L, Nuño L, Sciré CA, Govoni M, et al. Clinicalspectrum time course in anti Jo-1 positive antisynthetasesyndrome: Medicine (Baltimore) 2015; 94 (32): e1144. doi:10.1097/MD.0000000000001144.

  13. Cavagna L, Nuño L, Sciré CA, Govoni M. Serum Jo-1 autoantibodyand isolated arthritis in the antisynthetase syndrome:review of the literature and report of the experienceof AENEAS collaborative group. Clin Rev Allergy Immunol2017; 52 (1): 71-80. doi: 10.1007/s12016-016-8528-9.

  14. Lefèvre G, Meyer A, Launay D, Machelart I, et al. Seronegativepolyarthritis revealing antisynthetase syndrome: amulticenter study of 40 patients. Rheumatology 2015; 54:927-932. doi: 10.1093/rheumatology/keu404.

  15. Tallero-Araguás E, Grau-Junyent JM, Labirua-Iturburo A,García-Hernández FJ, et al. Clinical manifestations andlong-term outcome of anti-Jo1 antisynthetase patientsin a large cohort of spanish patients from the GEAS-IIMgroup. Semin Arthritis Rheum 2016; 46 (2): 225-231. doi:10.1016/j.semarthrit.2016.03.011.

  16. Marie I, Josse S, Hatron PY, Dominique S, et al. Interstitiallung disease in anti-Jo-1 patients with antisynthetase syndrome.Arthritis Care Res (Hoboken) 2013; 65 (5): 800-8.doi: 10.1002/acr.21895.

  17. Debray MP, Borie R, Revel MP, Naccache JM, et al. Interstitiallung disease in anti-synthetase syndrome: initial andfollow-up CT findings. Eur J Radiol 2015; 84 (3): 516-523.doi: 10.1016/j.ejrad.2014.11.026.

  18. Zamora AC, Hoskote SS, Abascal-Bolado B, White D, et al.Clinical features and outcomes of interstitial lung diseasein anti-Jo-1 positive antisynthetase syndrome. Respir Med2016; 118: 39-45. doi: 10.1016/j.rmed.2016.07.009.

  19. Labirua-Iturburo A, Selva-O’Callaghan A, Vincze M, DankóK, et al. Anti-PL-7 (anti-threonyl-tRNA synthetase) antisynthetasesyndrome: clinical manifestations in a series ofpatients from a european multicenter study (EUMYONET)and review of literature. Medicine 2012; 91: 206-211. doi:10.1097/MD.0b013e318260977c.

  20. Shi J, Li S, Yang H, Zhang Y, et al. Clinical profiles andprognosis of patients with distinct antisynthetase antibodies.J Rheumatol 2017; 44 (7): 1051-1057. doi: 10.3899/jrheum.161480.

  21. Marie I, Josse S, Decaux O, Diot E, et al. Clinical manifestationsand outcome of anti-PL7 positive patients withantisynthetase syndrome. Eur J Intern Med 2013; 24 (5):474-9. doi: 10.1016/j.ejim.2013.01.002.

  22. Souza FH, Cruellas MG, Levy-Nieto M, Shinjo S. Antisynthetasesyndrome: anti-PL-7, anti-PL-12, and anti-EJ.Rev Bras Reumatol 2013; 53 (4): 352-7. doi: 10.1590/s0482-50042013000400007.

  23. Kalluri M, Sahn SA, Oddis CV, Gharib S, et al. Clinical profileof anti-PL-12 autoantibody: cohort study and review ofthe literature. Chest 2009; 135: 1150-1556. doi: 10.1378/chest.08-2233.

  24. Marie I, Josse S, Decaux O, Dominique S, et al. Outcome ofanti-PL2 positive patients with antisynthetase syndrome.Presse Med 2013; 42 (6 Pt 1): e153-8. doi: 10.1016/j.lpm.2012.12.003.

  25. Marie I, Josse S, Decaux O, Diot E, et al. Comparison of longtermoutcome between anti-Jo-1 and anti-PL7/PL12 positi-ve patients with antisynthetase syndrome. Autoimmun Rev2012; 11 (10): 739-45. doi: 10.1016/j.autrev.2012.01.006.

  26. Hamaguchi Y, Fujimoto M, Matsushita T, Kaji K, et al. Commonand distinct clinical features in adult patients withanti-aminoacyl-tRNA synthetase antibodies: heterogeneitywithin the syndrome. PLoS One 2013; 8 (4): e60442. doi:10.1371/journal.pone.0060442.

  27. Noguchi E, Uruha A, Suzuki S, Hamanaka K, et al. Skeletal muscleinvolvement in antisynthetase syndrome. JAMA Neurol2017; 74 (8): 992-999. doi: 10.1001/jamaneurol.2017.0934.

  28. Schneider F, Yousem SA, BI D, Gibson K, et al. Pulmonarypathologic manifestations of anti-glycyl-tRNA synthetase(anti-EJ)-related inflammatory myopathy. J Clin Pathol2014; 67: 678-683. doi: 10.1136/jclinpath-2014-202367.

  29. Ota M, Kihara M, Takamura A, Kohsaka H. Anti-EJ antibodypositive lung disease with skin changes at the fingertips.Nihon Rinsho Meneki Gakkai Kaishi 2016; 39 (2): 150-3.doi: 10.2177/jsci.39.150.

  30. Schneider F, Aggarwal R, Bi D, Gibson K, et al. The pulmonaryhistopathology of anti-KS transfer RNA synthetasesyndrome. Arch Pathol Lab Med 2015; 139: 122-125. doi:10.5858/arpa.2013-0667-OA.

  31. Vulsteke JB, Satoh M, Malyavantham K, Bossuyt X, et al. Anti-OJ autoantibodies: rare or underdetected? Autoimmun Rev2019; 18 (7): 658-664. doi: 10.1016/j.autrev.2019.05.002.

  32. Sebastiani M, Triantafyllias K, Manfredi A, González-GayMA. et al. Nailfold capillaroscopy characteristics of antisynthetasesyndrome and possible clinical associations:results of a multicenter international study. J Rheumatol2019; 46 (3): 279-284. doi: 10.3899/jrheum.180355.

  33. Soubrier C, Seguier J, DI Costanzo MP, Ebbo M, et al. Nailfoldvideocapillaroscopy alterations in dermatomyositis,antisynthetase syndrome, overlap myositis, and immunemediatednecrotizing myopathy. Clin Rheumatol 2019; 38(12): 3451-3458. doi: 10.1007/s10067-019-04710-2.

  34. Aggarwal R, Dhillon N, Fertig N, Koontz D, et al. A negativeantinuclear antibody does not indicate autoantibody negativityin myositis: role of anticytoplasmic antibody as ascreening test for antisynthetase syndrome. J Rheumatol2017; 44 (2): 223-229. doi: 10.3899/jrheum.160618.

  35. Choy EH, Isenberg DA. Treatment of dermatomyositis andpolymiositis. Rheumatology (Oxford) 2002; 41 (1): 7-13.doi: 10.1093/rheumatology/41.1.7.

  36. Griger Z, Nagy-Vince M, Dankó K. Pharmacological managementof dermatomyositis. Expert Rev Clin Pharmacol 2017;10 (10): 1109-1118. doi: 10.1080/17512433.2017.1353910.

  37. Barba T, Fort R, Cottin V, Provencher S, et al. Treatmentof idiopathic inflammatory myositis associated interstitiallung disease: a systematic review and meta-analysis.Autoimmun Rev 2019; 18 (2): 113-122. doi: 10.1016/j.autrev.2018.07.013.

  38. Casal-Dominguez M, Pinal-Fernandez I, Huapaya J, AlbaydaJ, et al. Efficacy and adverse effects of methotrexate comparedwith azathioprine in the antisynthetase syndrome.Clin Exp Rheumatol 2019; 37 (5): 858-861.

  39. Huapaya JA, Silhan L, Pinal-Fernández I, Casal-Domínguez,et al. Long-term treatment with azathioprine and mycophenolatemofetil for myositis-related interstitial lungdisease. Chest 2019; 156 (5): 896-906. doi: 10.1016/j.chest.2019.05.023.

  40. Labirua-Iturburu A, Selva-O’Callaghan A, Martínez-GómezX, Trallero-Araguás E, et al. Calcineurin inhibitors in a cohortof patients with antisynthetase-associated interstitial lungdisease. Clin Exp Rheumatol 2013; 31 (3): 436-9.

  41. Cavagna L, Caporali R, Abdì-Alì L, Dore R, et al. Cyclosporinein anti-Jo1-positive patients with corticosteroid-refractoryinterstitial lung disease. J Rheumatol 2013; 40 (4): 484-92.doi: 10.3899/jrheum.121026.

  42. Allenbach Y, Guiguet M, Rigolet A, Marie I, et al. Efficacyof rituximab in refractory inflammatory myopathies associatedwith anti-synthetase auto-antibodies: an openlabel, phase II trial. PLoS One 2015; 10 (11): e0133702.doi: 10.1371/journal.pone.0133702.

  43. Andersson H, Sem M, Lund MB, Aaløkken T, et al. Long-termexperience with rituximab in anti-synthetase-related interstitiallung disease. Rheumatology 2015; 54: 1420-1428. doi:10.1093/rheumatology/kev004.

  44. Doyle TJ, Dhillon N, Madan R, Cabral F, et al. Rituximab inthe treatment of interstitial lung disease associated withantisynthetase syndrome: a multicenter retrospective casereview. J Rheumatol 2018; 45 (6): 841-850. doi: 10.3899/jrheum.170541.

  45. Marie I, Dominique S, Janvresse A, Levesque H, Menard J.Rituximab therapy for refractory interstitial lung diseaserelated to antisynthetase syndrome. Respir Med 2012; 106(4): 581-7. doi: 10.1016/j.rmed.2012.01.001.




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