Small cohort studies have demonstrated more severe ILD (defined as greater extent of fibrosis on HRCT and impairment of pulmonary function measures), and greater resistance to immunosuppressive therapy in anti-Jo-1 positive myositis patients with concomitant anti-SSA/Ro antibodies compared with anti-SSA/Ro negative patients [119,120]. Here, TRIM21 is linked to interstitial lung disease.