Christensen M L, Pachman L M, Schneiderman R, Patel D C, Friedman J M
Arthritis Rheum. 1986 Nov;29(11):1365-70. doi: 10.1002/art.1780291109.
A number of viruses have been implicated as being the cause of various forms of myositis, including acute transient myositis, chronic polymyositis, and dermatomyositis. However, the cause of juvenile dermatomyositis (JDM) has remained elusive. Our study of serum samples taken within 4 months of the onset of disease in 12 children with JDM showed that 83% had detectable titers of complement-fixing (CF) antibody to 1 or more coxsackie B viral antigens. Detectable titers were found in only 25% of age-, sex-, and date-matched control sera taken from 24 patients with juvenile rheumatoid arthritis (JRA), and in 25% of serum samples taken from 2,192 "normal" children who had been hospitalized because of viral syndromes. Titers of CF antibody to coxsackie B1, B2, and B4 were positive in 58%, 50%, and 58%, respectively, of the JDM patients. In matched JRA controls, the respective values were 8%, 13%, and 8%. There were no significant antiviral titers and no significant differences in the results of tests for 13 other viral CF antigens, hepatitis B surface antigen, and Mycoplasma pneumoniae CF antigen in the JDM patient sera compared with the JRA patient sera. When titers of neutralizing antibody were determined, 58%, 58%, and 67% of the JDM patients were positive for coxsackie B2, B4, and B5, respectively, whereas 16%, 26%, and 21%, respectively, of the JRA controls were positive for the 3 antigens. These data suggest that the host response to coxsackie B virus might be related to the pathophysiology of JDM.
多种病毒被认为是各种形式肌炎的病因，包括急性短暂性肌炎、慢性多发性肌炎和皮肌炎。然而，青少年皮肌炎（JDM）的病因仍不清楚。我们对12例JDM患儿在发病4个月内采集的血清样本进行研究，结果显示，83%的患儿针对1种或多种柯萨奇B病毒抗原的补体结合（CF）抗体滴度可检测到。在24例青少年类风湿性关节炎（JRA）患者中，按年龄、性别和日期匹配的对照血清中只有25%可检测到抗体滴度，在2192例因病毒综合征住院的“正常”儿童的血清样本中，这一比例为25%。JDM患者中，针对柯萨奇B1、B2和B4的CF抗体滴度分别有58%、50%和58%呈阳性。在匹配的JRA对照中，相应的值分别为8%、13%和8%。与JRA患者血清相比，JDM患者血清中针对其他13种病毒CF抗原、乙肝表面抗原和肺炎支原体CF抗原的检测结果，抗病毒滴度无显著差异。当检测中和抗体滴度时，JDM患者中分别有58%、58%和67%针对柯萨奇B2、B4和B5呈阳性，而JRA对照中针对这3种抗原呈阳性的比例分别为16%、26%和21%。这些数据表明，宿主对柯萨奇B病毒的反应可能与JDM的病理生理学有关。
