Exercise as a potential modulator in anti-Jo-1 positivity: A case report of long-term serological and radiographic...

The anti-Jo-1 antibody is a hallmark myositis-specific autoantibody strongly associated with antisynthetase syndrome, a multisystem autoimmune disorder characterized by interstitial lung disease, myositis, and arthritis. While its detection typically heralds clinical disease onset, the natural history and optimal management of individuals with isolated anti-Jo-1 positivity who remain asymptomatic remain poorly defined, posing a clinical dilemma regarding monitoring and early intervention.

A 34-year-old woman presented with incidentally detected anti-Jo-1 antibody positivity during routine screening, remaining entirely asymptomatic throughout the subsequent 6-year observation period.

Persistent anti-Jo-1 antibody positivity accompanied by stable functional and imaging results, consistent with an asymptomatic, non‑progressive carrier state of anti‑Jo‑1 antibody positivity.

Given the absence of clinical symptoms or objective evidence of systemic inflammation, a strategy of regular surveillance was adopted without initiating immunosuppressive therapy. The patient was encouraged to maintain her regular lifestyle, including at least 150 minutes of moderate-intensity aerobic exercise per week. She underwent clinical and serological assessment every 6 to 12 months and annual thoracic high-resolution computed tomography over a 6-year follow-up period.

The patient remained entirely asymptomatic throughout 6 years of observation. Serial high-resolution computed tomography scans demonstrated no radiological progression, with stable nodules and no emergence of new findings suggestive of interstitial lung disease, such as reticulation, honeycombing, or consolidation. Inflammatory markers consistently remained within normal ranges.

This case reinforces that anti-Jo-1 positivity does not invariably lead to clinical disease and supports a conservative, surveillance-based approach in asymptomatic carriers. The potential immunomodulatory role of sustained physical activity highlights the importance of integrating lifestyle assessment into management, while further research is needed to stratify risk and guide intervention timing.