Anti-Ro Antibody Positivity and Its Relationship With Pulmonary Involvement in Systemic Sclerosis

Aim: Pulmonary involvement is a major contributor to both morbidity and mortality in systemic sclerosis (SSc). While specific autoantibodies, such as anti-Scl-70 and anti-centromere, have been linked to distinct disease subtypes and organ complications, the role of anti-Ro antibodies in SSc—particularly in relation to pulmonary manifestations—has not been fully elucidated. Understanding this relationship may provide insights into disease stratification and risk assessment for lung involvement in SSc patients. This study aimed to determine the prevalence of anti-Ro antibodies in patients with SSc and to investigate their potential association with pulmonary complications, including interstitial lung disease and pulmonary arterial hypertension. Material and Methods: We retrospectively reviewed 73 patients with SSc who underwent anti-Ro antibody testing, chest X-rays, and high-resolution computed tomography (HRCT). Serum levels of anti-Scl-70, anti-centromere, anti-Ro, and anti-La antibodies were measured using enzyme-linked immunosorbent assay, with a positivity threshold of ≥21 IU/mL, while antinuclear antibodies (ANA) were assessed via indirect immunofluorescence. Pulmonary changes were evaluated by imaging, with particular attention to reticular patterns, ground-glass opacities, and honeycombing. Results: ANA positivity was observed in 94.5% of patients. Anti-Scl-70 and anti-centromere antibodies were detected in 52.8% and 18.8% of patients, respectively. Anti-Ro antibodies were positive in six patients (8.2% of the cohort); all were also ANA-positive. Two patients (2.7% of the cohort) were positive for anti-Scl-70, while none exhibited anti-centromere antibodies. Pulmonary abnormalities were more frequently observed in anti-Ro-positive patients on both chest radiographs and HRCT, although these differences did not reach statistical significance. Conclusion: Anti-Ro antibodies were uncommon in SSc, but were associated with a non-significant trend toward increased pulmonary involvement. Larger prospective studies, especially evaluating anti-Ro52, are needed to clarify their clinical relevance.