From the National Institute of Arthritis and Musculoskeletal and Skin Diseases (I.P.-F, M.C.-D, A.D., K.P., P.P., F.W.M., A.L.M.), NIH, Bethesda; Johns Hopkins University School of Medicine (I.P.-F., M.C.-D., J.P., J.A., L.C.-S., T.E.L., A.M.C., A.L.M.), Baltimore, MD; Clinic Hospital and the University of Barcelona (J.C.M., J.M.G.-J.); Vall d'Hebron Hospital and Autonomous University of Barcelona (A.S.-O.); and Faculty of Health Sciences (I.P.-F.), Universitat Oberta de Catalunya, Barcelona, Spain.
Neurology. 2019 Sep 17;93(12):e1193-e1204. doi: 10.1212/WNL.0000000000008128. Epub 2019 Aug 21.
Activation of the type 1 interferon (IFN1) pathway is a prominent feature of dermatomyositis (DM) muscle and may play a role in the pathogenesis of this disease. However, the relevance of the IFN1 pathway in patients with other types of myositis such as the antisynthetase syndrome (AS), immune-mediated necrotizing myopathy (IMNM), and inclusion body myositis (IBM) is largely unknown. Moreover, the activation of the type 2 interferon (IFN2) pathway has not been comprehensively explored in myositis. In this cross-sectional study, our objective was to determine whether IFN1 and IFN2 pathways are differentially activated in different types of myositis by performing RNA sequencing on muscle biopsy samples from 119 patients with DM, IMNM, AS, or IBM and on 20 normal muscle biopsies.
The expression of IFN1- and IFN2-inducible genes was compared between the different groups.
The expression of IFN1-inducible genes was high in DM, moderate in AS, and low in IMNM and IBM. In contrast, the expression of IFN2-inducible genes was high in DM, IBM, and AS but low in IMNM. The expression of IFN-inducible genes correlated with the expression of genes associated with inflammation and muscle regeneration. Of note, expression levels alone performed as well as composite scores relying on multiple genes to monitor activation of the IFN1 pathway in myositis muscle biopsies.
IFN1 and IFN2 pathways are differentially activated in different forms of myositis. This observation may have therapeutic implications because immunosuppressive medications may preferentially target each of these pathways.
1 型干扰素(IFN1)途径的激活是皮肌炎(DM)肌肉的一个显著特征,可能在该疾病的发病机制中起作用。然而,IFN1 途径在其他类型的肌炎患者中的相关性,如抗合成酶综合征(AS)、免疫介导的坏死性肌病(IMNM)和包涵体肌炎(IBM),在很大程度上尚不清楚。此外,IFN2 途径的激活在肌炎中尚未得到全面探讨。在这项横断面研究中,我们的目的是通过对 119 例 DM、IMNM、AS 或 IBM 患者和 20 例正常肌肉活检样本进行 RNA 测序,确定 IFN1 和 IFN2 途径在不同类型的肌炎中是否存在差异激活。
比较了不同组之间 IFN1 和 IFN2 诱导基因的表达。
IFN1 诱导基因的表达在 DM 中较高,在 AS 中中等,在 IMNM 和 IBM 中较低。相比之下,IFN2 诱导基因的表达在 DM、IBM 和 AS 中较高,但在 IMNM 中较低。IFN 诱导基因的表达与与炎症和肌肉再生相关的基因表达相关。值得注意的是,单独的表达水平与依赖于多个基因的综合评分一样,可用于监测肌炎肌肉活检中 IFN1 途径的激活。
IFN1 和 IFN2 途径在不同形式的肌炎中存在差异激活。这一观察结果可能具有治疗意义,因为免疫抑制药物可能会优先针对这些途径中的每一种。