National Institutes of Health Clinical Research Center, Bethesda, Maryland, USA.
Curr Opin Rheumatol. 2011 Nov;23(6):585-94. doi: 10.1097/BOR.0b013e32834b5457.
Increasing evidence suggests that the idiopathic inflammatory myopathies (IIMs) result from certain environmental exposures in genetically susceptible individuals. Investigations have demonstrated that a variety of infections not only cause infectious myopathies but also could be possible triggers for IIM. This review summarizes published studies on the possible roles of infections in inflammatory muscle disease.
Many infectious agents have been linked to the development of IIMs via case reports, epidemiologic investigations, and animal models. Additional agents possibly involved in triggering the development of IIMs have been recently described, including Torque teno virus (TTV) and Borrelia burgdorferi. Novel animal models of myositis have been recently developed using Leishmania infantum or Chikungunya virus (CHIKV). New technologies to assess infectious agents include high-throughput methods for pathogen identification and novel approaches to identify gene expression of pathogens in tissues.
Understanding the causes of IIMs remains limited in part due to the rarity and heterogeneity of these disorders. Although no definitive studies have yet linked infectious agents with IIMs, additional evidence is accumulating and novel technologies may allow improved understanding of the roles of infections in IIMs and for possible future therapeutic and preventive measures.
越来越多的证据表明，特发性炎性肌病（IIM）是由遗传易感个体接触某些环境因素引起的。研究表明，多种感染不仅会导致感染性肌病，还可能是 IIM 的潜在触发因素。本综述总结了已发表的关于感染在炎性肌病中可能作用的研究。
许多传染病通过病例报告、流行病学调查和动物模型与 IIM 的发生有关。最近还描述了其他可能参与触发 IIM 发展的病原体，包括 Torque teno 病毒（TTV）和伯氏疏螺旋体（Borrelia burgdorferi）。最近使用利什曼原虫或基孔肯雅病毒（CHIKV）开发了新型肌炎动物模型。用于评估病原体的新技术包括病原体鉴定的高通量方法以及在组织中鉴定病原体基因表达的新方法。
由于这些疾病的罕见性和异质性，对 IIM 病因的了解仍然有限。尽管目前还没有明确的研究将感染因子与 IIM 联系起来，但越来越多的证据正在积累，新的技术可能会提高我们对感染在 IIM 中的作用的理解，并为未来可能的治疗和预防措施提供依据。
