Based on the first clustering analysis in a large sample of anti-MDA5+DM patients in Asia, which revealed the characteristics of RP-ILD in high-inflammatory state anti-MDA5+DM patients, the coexistence of anti-Ro-52 antibodies and anti-MDA5 antibodies predicted high-risk RP-ILD patients (43). Here, TRIM21 is linked to dermatomyositis.