Love Lori A, Weinberg Clarice R, McConnaughey D Robert, Oddis Chester V, Medsger Thomas A, Reveille John D, Arnett Frank C, Targoff Ira N, Miller Frederick W
Institute of Environmental Health Sciences, NIH, Research Triangle Park, North Carolina, USA.
Arthritis Rheum. 2009 Aug;60(8):2499-504. doi: 10.1002/art.24702.
Because studies suggest that ultraviolet (UV) radiation modulates the myositis phenotype and Mi-2 autoantigen expression, we conducted a retrospective investigation to determine whether UV radiation may influence the relative prevalence of dermatomyositis and anti-Mi-2 autoantibodies in the US.
We assessed the relationship between surface UV radiation intensity in the state of residence at the time of onset with the relative prevalence of dermatomyositis and myositis autoantibodies in 380 patients with myositis from referral centers in the US. Myositis autoantibodies were detected by validated immunoprecipitation assays. Surface UV radiation intensity was estimated from UV Index data collected by the US National Weather Service.
UV radiation intensity was associated with the relative proportion of patients with dermatomyositis (odds ratio [OR] 2.3, 95% confidence interval [95% CI] 0.9-5.8) and with the proportion of patients expressing anti-Mi-2 autoantibodies (OR 6.0, 95% CI 1.1-34.1). Modeling of these data showed that these associations were confined to women (OR 3.8, 95% CI 1.3-11.0 and OR 17.3, 95% CI 1.8-162.4, respectively) and suggests that sex influences the effects of UV radiation on autoimmune disorders. Significant associations were not observed in men, nor were UV radiation levels related to the presence of antisynthetase or anti-signal recognition particle autoantibodies.
This first study of the distribution of myositis phenotypes and UV radiation exposure in the US showed that UV radiation may modulate the clinical and immunologic expression of autoimmune disease in women. Further investigation of the mechanisms by which these effects are produced may provide insights into pathogenesis and suggest therapeutic or preventative strategies.
由于研究表明紫外线（UV）辐射可调节肌炎表型和Mi-2自身抗原表达，我们进行了一项回顾性研究，以确定紫外线辐射是否可能影响美国皮肌炎和抗Mi-2自身抗体的相对患病率。
我们评估了发病时居住州的地表紫外线辐射强度与来自美国转诊中心的380例肌炎患者中皮肌炎和肌炎自身抗体相对患病率之间的关系。通过经过验证的免疫沉淀试验检测肌炎自身抗体。地表紫外线辐射强度根据美国国家气象局收集的紫外线指数数据估算。
紫外线辐射强度与皮肌炎患者的相对比例相关（优势比[OR] 2.3，95%置信区间[95%CI] 0.9 - 5.8），也与表达抗Mi-2自身抗体的患者比例相关（OR 6.0，95%CI 1.1 - 34.1）。对这些数据的建模显示，这些关联仅限于女性（分别为OR 3.8，95%CI 1.3 - 11.0和OR 17.3，95%CI 1.8 - 162.4），这表明性别会影响紫外线辐射对自身免疫性疾病的作用。在男性中未观察到显著关联，紫外线辐射水平也与抗合成酶或抗信号识别颗粒自身抗体的存在无关。
这项关于美国肌炎表型分布和紫外线辐射暴露的首次研究表明，紫外线辐射可能调节女性自身免疫性疾病的临床和免疫表达。对产生这些效应的机制进行进一步研究可能有助于深入了解发病机制，并提出治疗或预防策略。
