While the presence of anti-MDA5 antibodies is associated with increased risk for the development of ILD and consequently increased risk for mortality, Chen et al. (53) the concomitant presence of anti-Ro-52 antibodies is associated with worse outcomes, increased risk of progression to RP-ILD, and decreased rates of survival as evidenced in recent Asian cohorts studies (54–56). The gene discussed is TRIM21; the disease is interstitial lung disease.