Patwardhan Anjali
Child Health, University of Missouri, Columbia, USA.
Cureus. 2020 Feb 19;12(2):e7049. doi: 10.7759/cureus.7049.
The understanding of etiology and pathogenesis of idiopathic immune myositis is fast evolving, and so is the classification of myositis subtypes. The diversity in genetics, major histocompatibility complex expressions, immunohistochemical, and specific and associated autoantibodies not only explains the individual variability in response to therapies but also begs for subtype-specific treatments. With the evolution of the new biological therapies, the treatment of idiopathic immune myositis (IIM) has greatly transformed in recent years. This article appraises the current therapeutic value of intravenous immunoglobulin (IVIg) in idiopathic immune myopathy patients in the era of transformed treatment options. This article argues why the IVIg therapy still retains its value as an unreplaceable treatment option in certain specific subtypes of idiopathic immune myositis patients as well as in certain specific clinical idiopathic immune myositis scenarios.
对特发性免疫性肌炎病因和发病机制的理解正在迅速发展,肌炎亚型的分类也是如此。遗传学、主要组织相容性复合体表达、免疫组织化学以及特异性和相关自身抗体的多样性不仅解释了个体对治疗反应的变异性,也迫切需要亚型特异性治疗。随着新生物疗法的发展,近年来特发性免疫性肌炎(IIM)的治疗发生了巨大变化。本文评估了在治疗选择发生转变的时代,静脉注射免疫球蛋白(IVIg)对特发性免疫性肌病患者的当前治疗价值。本文探讨了为什么IVIg疗法在特发性免疫性肌炎患者的某些特定亚型以及某些特定临床特发性免疫性肌炎情况下,作为一种不可替代的治疗选择仍保留其价值。