Noda Tomoko, Iijima Masahiro, Noda Seiya, Maeshima Shinya, Nakanishi Hirotaka, Kimura Seigo, Koike Haruki, Ishigaki Shinsuke, Iguchi Yohei, Katsuno Masahisa, Sobue Gen
Department of Neurology, Nagoya University Graduate School of Medicine, Japan.
Intern Med. 2016;55(18):2571-80. doi: 10.2169/internalmedicine.55.6706. Epub 2016 Sep 15.
Objective An association has been reported between inflammatory myopathies (IMs), which include polymyositis (PM) and dermatomyositis (DM), and malignancy, and the concept of cancer-associated myositis (CAM) was recently proposed. We herein attempted to determine the features and etiologies of these myopathies. Methods We analyzed the gene expression levels via microarray and real-time quantitative reverse transcription polymerase chain reaction analyses to identify genes that were specifically upregulated or downregulated with suspected inflammatory involvement and verified the microarray data via an immunohistochemical (IHC) analysis in additional cases. Patients We selected 14 patients with the following conditions: PM without malignancy (n=3), DM without malignancy (n=3), CAM (n=3), and Controls (no pathological changes or malignancy; n=5). Results PM was distinct from DM and CAM in a clustering analysis and exhibited the highest numbers of overexpressed genes and specific pathologies in a gene ontology analysis. The IHC analysis confirmed the gene expression results. Conclusion PM is associated with severe inflammatory pathological findings, primarily in the cell-mediated immune system. DM and CAM exhibit similarities in the gene expression and IHC results, which suggest that humoral immunity is the main etiology for both myopathies, indicating the importance of cancer screening in patients with IMs, particularly DM.
目的 已有报道称，包括多发性肌炎（PM）和皮肌炎（DM）在内的炎性肌病（IM）与恶性肿瘤之间存在关联，最近还提出了癌症相关性肌炎（CAM）的概念。我们在此试图确定这些肌病的特征和病因。方法 我们通过微阵列和实时定量逆转录聚合酶链反应分析来分析基因表达水平，以鉴定在怀疑有炎症参与时特异性上调或下调的基因，并在其他病例中通过免疫组织化学（IHC）分析验证微阵列数据。患者 我们选择了14例患有以下疾病的患者：无恶性肿瘤的PM（n = 3）、无恶性肿瘤的DM（n = 3）、CAM（n = 3）和对照组（无病理变化或恶性肿瘤；n = 5）。结果 在聚类分析中，PM与DM和CAM不同，并且在基因本体分析中表现出最高数量的过表达基因和特定病理。IHC分析证实了基因表达结果。结论 PM主要与严重的炎症病理结果相关，主要存在于细胞介导的免疫系统中。DM和CAM在基因表达和IHC结果方面表现出相似性，这表明体液免疫是这两种肌病的主要病因，这表明对IM患者，尤其是DM患者进行癌症筛查的重要性。
