In conclusion, the present investigation has not only confirmed previous risk factors in anti-MDA5+-DM-associated RPILD, such as old age, ferritin, CRP, AST, CEA and anti-Ro52 Abs, but it has also identified anti-SAE Abs as a protective factor in Asian anti-MDA5 Abs-associated diseases, especially in those concurring with RPILDs with a high mortality rate. This evidence concerns the gene TRIM21 and dermatomyositis.