Anti-PL-7/PL-12 antisynthetase syndrome associated with interstitial lung disease following SARS-COV-2 infection and vaccination : A case study review
García-Bravo, L. (Hospital Clínico San Carlos (Madrid))
Villegas, Á. (Hospital Clínico San Carlos (Madrid))
López Uceda, B. (Hospital Clínico San Carlos (Madrid))
Mariscal, Anaís (Institut de Recerca Sant Pau)
Vadillo, C. (Hospital Clínico San Carlos (Madrid))
Nieto Barbero, Asunción (Hospital Clínico San Carlos (Madrid))
Rodríguez-Hermosa, J.L. (Hospital Clínico San Carlos (Madrid))
Mediero Valeros, B. (Hospital Clínico San Carlos (Madrid))
Plaza-Hernández, J.C. (Pathological Anatomy Department)
Fernández-Arquero, M. (Hospital Clínico San Carlos (Madrid))
Guzmán-Fulgencio, M. (Hospital Clínico San Carlos (Madrid))
Candelas-Rodríguez, G. (Hospital Clínico San Carlos (Madrid))
Sánchez-Ramón, S. (Hospital Clínico San Carlos (Madrid))
Ochoa-Grullón, Juliana (Hospital Clínico San Carlos (Madrid))
Universitat Autònoma de Barcelona

Date:	2025
Abstract:	Cumulative evidence suggests a link between specific autoimmune diseases (AD), including idiopathic inflammatory myopathies (IIM), and SARS-CoV-2 infection or COVID-19 vaccination. Anti-synthetase syndrome (ASS), a subset of IIM, is defined by the presence of autoantibodies against aminoacyl-tRNA synthetase (anti-ARS) and is strongly associated with interstitial lung disease (ILD), a major contributor to severe complications and reduced survival. We present four clinical cases of patients who developed autoantibodies against threonyl (PL-7) and alanyl (PL-12) synthetases associated with ASS-ILD shortly after SARS-CoV-2 infection or COVID-19 vaccination. Anti-ARS autoantibodies were identified using three complementary methods: immunoblotting, western blotting (WB) and the method considered the gold standard, immunoprecipitation (IP), which ensures accurate interpretation of results. The study highlights the clinical and pathogenic overlap between ASS-ILD and SARS-CoV-2-related lung involvement. Both conditions share similar high-resolution computed tomography (HRCT) patterns, including inflammation and pulmonary fibrosis (PF), driven by IFN-γ signaling, which complicates accurate diagnosis. Our results provide novel insights into the temporal association of SARS-CoV-2 and vaccine exposure with ASS-ILD, focusing on possible molecular mimicry between viral proteins and ARS molecules as a potential mechanism. Understanding the involvement of specific anti-ARS autoantibodies (PL-7 and PL-12) and the identification of genetic predispositions (HLA-B∗08:01 and HLA-DRB1∗03:01) in these patients may be key to underpinning these autoimmune manifestations. The study underscores the importance of a multidisciplinary approach and vigilant follow-up to optimize diagnosis and management. Further research is essential to elucidate the causal relationships and molecular mechanisms behind these observations.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Anti-synthetase syndrome ; COVID-19 ; Idiopathic inflammatory myopathies ; Interstitial lung disease ; SARS-CoV-2 vaccine
Published in:	Heliyon, Vol. 11 Núm. 2 (30 2025) , p. e41311, ISSN 2405-8440

DOI: 10.1016/j.heliyon.2024.e41311
PMID: 39906838

11 p, 6.0 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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