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皮肌炎的发病机制:肌肉中的叛逆士兵。

Dermatomyositis etiopathogenesis: a rebel soldier in the muscle.

机构信息

Muscle Disease Unit, Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda.

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

出版信息

Curr Opin Rheumatol. 2018 Nov;30(6):623-629. doi: 10.1097/BOR.0000000000000540.

Abstract

PURPOSE OF REVIEW

The purpose of this article is to review the etiopathogenesis of dermatomyositis, including the predisposing factors, triggers, inflammatory cells, pathways and target antigens associated with dermatomyositis.

RECENT FINDINGS

During the last few years, we have made considerable progress in unveiling the etiopathogenesis of dermatomyositis. In the first place, we have defined genes within the major histocompatibility complex locus as the greatest genetic risk factor for the disease. Second, we have demonstrated that certain environmental factors, as well as tumors, may trigger certain dermatomyositis subtypes. Moreover, we have established the importance of the interferon pathway in dermatomyositis pathogenesis compared with other myositis subtypes. But probably, the most remarkable advance has been the discovery of multiple autoantibodies that define groups of patients with characteristic clinical features, prognosis and response to treatment.

SUMMARY

Dermatomyositis cause and pathogenesis have proven to be a complex and fascinating task for the scientific community and the last decade has been full of new findings on how the disease starts and how it causes damage to different organ systems. However, we have still more questions than answers in this topic, answers that will be critical to understanding autoimmunity and finding effective therapies to dermatomyositis.

摘要

目的综述

本文旨在探讨皮肌炎的发病机制,包括皮肌炎相关的易感因素、触发因素、炎症细胞、通路和靶抗原。

最近的发现

在过去的几年中,我们在揭示皮肌炎的发病机制方面取得了相当大的进展。首先,我们已经确定了主要组织相容性复合体(MHC)基因座内的基因是该疾病最大的遗传风险因素。其次,我们已经证明某些环境因素以及肿瘤可能会引发某些皮肌炎亚型。此外,与其他肌炎亚型相比,我们已经确立了干扰素通路在皮肌炎发病机制中的重要性。但也许最显著的进展是发现了多种自身抗体,这些抗体定义了具有特征性临床特征、预后和治疗反应的患者群体。

总结

皮肌炎的病因和发病机制已被证明是科学界一项复杂而引人入胜的任务,过去十年中,关于疾病如何开始以及如何导致不同器官系统损伤的新发现层出不穷。然而,在这个主题上,我们还有更多的问题没有答案,这些答案对于理解自身免疫和寻找皮肌炎的有效治疗方法至关重要。

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