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多发性肌炎/皮肌炎的肺部表现

Pulmonary manifestations of polymyositis/dermatomyositis.

作者信息

Hallowell Robert W, Ascherman Dana P, Danoff Sonye K

机构信息

Division of Pulmonary and Critical Medicine, John Hopkins School of Medicine, Baltimore, Maryland.

Division of Rheumatology, University of Miami Health System, Miami, Florida.

出版信息

Semin Respir Crit Care Med. 2014 Apr;35(2):239-48. doi: 10.1055/s-0034-1371528. Epub 2014 Mar 25.

Abstract

The idiopathic inflammatory myopathies are a group of connective tissue diseases marked by varying degrees of muscle inflammation and clinical involvement of multiple organs, most notably, the lung. Pulmonary manifestations consist primarily of interstitial lung disease (ILD), which is associated with significant morbidity and mortality in myositis patients. Several myositis-specific antibodies have been discovered, as well as antibodies targeting various aminoacyl-tRNA synthetase enzymes. These antibodies are associated with various clinical features and a risk for developing ILD, and their presence carries a prognostic value in myositis patients. Steroids remain the first-line treatment for myositis-associated ILD and the antisynthetase syndrome, though other traditional immunosuppressants have demonstrated efficacy in numerous studies. While a majority of patients experience either stabilization or improvement in lung imaging and function, fatal progression is still reported in a significant number of cases. Further research is needed to develop more effective and targeted therapies.

摘要

特发性炎性肌病是一组结缔组织疾病,其特征是不同程度的肌肉炎症以及多器官(最显著的是肺部)的临床受累。肺部表现主要由间质性肺疾病(ILD)组成,这在肌炎患者中与显著的发病率和死亡率相关。已经发现了几种肌炎特异性抗体,以及针对各种氨酰 - tRNA合成酶的抗体。这些抗体与各种临床特征以及发生ILD的风险相关,并且它们的存在对肌炎患者具有预后价值。类固醇仍然是治疗肌炎相关ILD和抗合成酶综合征的一线药物,尽管其他传统免疫抑制剂在众多研究中已证明有效。虽然大多数患者的肺部影像学和功能会稳定或改善,但仍有相当数量的病例报告出现致命进展。需要进一步研究以开发更有效和有针对性的治疗方法。

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