ORIGINAL RESEARCH article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1661334
This article is part of the Research TopicAutoinflammatory novelties: from pathogenic mechanisms to clinical and therapeutic implicationsView all 8 articles
Dual vs. Isolated Anti-Ro Antibody Positivity in Rheumatoid Arthritis
Provisionally accepted
- Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Objective: This study aimed to evaluate the clinical and immunological significance of anti-Ro52/TRIM21 and anti-Ro60/SSA antibodies in rheumatoid arthritis (RA), particularly the association of dual antibody positivity with disease severity, systemic manifestations, and therapeutic resistance.Methods: We conducted a cohort study involving 670 RA patients, stratified into four groups according to anti-Ro52 and anti-Ro60 antibody status: Ro52+/Ro60+, Ro52+/Ro60-, Ro52-/Ro60+, and Ro52-/Ro60-. Clinical characteristics, disease activity scores (DAS28-ESR, DAS28-CRP), systemic complications, and treatment responses were compared among groups. Multivariate logistic regression models identified independent predictors of difficult-to-treat RA (D2T-RA).Results: Patients with dual Ro52+/Ro60+ positivity exhibited significantly higher disease activity (median DAS28-ESR: 4.97 vs. 4.39, p = 0.002), worse functional status (median HAQ-DI: 0.88 vs. 0.63, p = 0.001), and increased systemic complications, notably interstitial lung disease (OR = 4.14, 95% CI: 1.71-10.68, p = 0.002) and hematologic involvement (OR = 2.50, 95% CI: 1.02-6.19, p = 0.044), compared to antibody-negative patients. Dual antibody positivity independently predicted an increased risk of developing D2T-RA (OR = 4.05, 95% CI: 1.58-11.09, p = 0.004). Conversely, patients with isolated Ro60 positivity exhibited lower IgG levels, fewer systemic complications, and reduced reliance on biological therapies, indicating a less severe disease phenotype.Conclusion: Anti-Ro antibody subtyping effectively identifies distinct clinical and immunological RA subgroups. Patients with isolated Ro60 antibody positivity display a relatively less severe clinical profile compared to those with dual antibody positivity, highlighting the importance of specific antibody profiles in guiding personalized clinical management and therapeutic decision-making.
Keywords: rheumatoid arthritis (RA), Anti-Ro52 antibody, Anti-Ro60 antibody, Difficult-to-Treat Rheumatoid Arthritis (D2T-RA), Anti-Ro antibody subtyping
Received: 07 Jul 2025; Accepted: 26 Jul 2025.
Copyright: © 2025 Ma, Gu, Li and Liangjing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lu Liangjing, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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