Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8602, Japan.
Scleroderma/Myositis Center of Excellence, Nippon Medical School Hospital, Tokyo, Japan.
Curr Rheumatol Rep. 2023 Dec;25(12):264-275. doi: 10.1007/s11926-023-01120-x. Epub 2023 Nov 16.
This review aims to evaluate recent findings on the role of environmental factors in the development and clinical presentation of idiopathic inflammatory myopathies (IIMs).
A targeted literature review was conducted to identify reports relevant to the association between environmental factors and IIMs published over the past three years. There has been an increasing number of publications dealing with the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or vaccination with the development of IIMs, highlighting the significant role of the antiviral immune response in the pathogenesis of the disease. Traditional environmental factors associated with the pathogenic process of IIM subclassifications included drugs such as statins and immune checkpoint inhibitors, ultraviolet radiation, smoking, air pollutants, and vitamin D deficiency. Correlations of seasonality and residence with the onset of certain IIM subtypes suggest a potential role of environmental triggers in the pathogenic process. An interplay between genetic predisposition and various environmental factors might contribute to the development of IIMs as well as the heterogeneous clinical and serological presentation of IIMs. The growing evidence on the role of environmental factors in the development of IIMs provides important clues to elucidate the pathophysiology of these disease entities. The mechanisms underlying the interactions between genetic predisposition and environmental factors should be investigated in the future.
本综述旨在评估环境因素在特发性炎性肌病(IIM)发病机制和临床表现中的作用的最新研究结果。
对过去三年中发表的与环境因素与 IIM 相关的报告进行了针对性文献回顾。越来越多的出版物涉及严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染或接种疫苗与 IIM 发病之间的关联,突出了抗病毒免疫反应在疾病发病机制中的重要作用。与 IIM 分类亚类发病机制相关的传统环境因素包括他汀类药物和免疫检查点抑制剂、紫外线辐射、吸烟、空气污染物和维生素 D 缺乏等药物。季节性和居住环境与某些 IIM 亚型发病的相关性提示环境触发因素在发病机制中可能发挥作用。遗传易感性和各种环境因素之间的相互作用可能导致 IIM 的发生以及 IIM 的异质临床和血清学表现。越来越多的证据表明环境因素在 IIM 的发病机制中起作用,为阐明这些疾病实体的病理生理学提供了重要线索。未来应研究遗传易感性与环境因素相互作用的机制。