Autoimmune inflammatory myopathies.

Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0166161 Publication Model: Print Cited Medium: Internet ISSN: 0072-9752 (Print) Linking ISSN: 00729752 NLM ISO Abbreviation: Handb Clin Neurol Subsets: MEDLINE

Publication: <1985- >: Amsterdam ; New York : Elsevier
Original Publication: Amsterdam [Netherlands] : New York : North-Holland Pub. Co. ; Wiley Interscience Division - John Wiley & Sons, [©1969-

Myositis, Inclusion Body*/diagnosis ; Myositis, Inclusion Body*/therapy ; COVID-19* ; Myositis*/diagnosis ; Myositis*/therapy ; Autoimmune Diseases*/diagnosis ; Autoimmune Diseases*/therapy; Humans ; Inflammation ; Autoantibodies

The autoimmune inflammatory myopathies constitute a heterogeneous group of acquired myopathies that have in common the presence of endomysial inflammation and moderate to severe muscle weakness. Based on currently evolved distinct clinical, histologic, immunopathologic, and autoantibody features, these disorders can be best classified as dermatomyositis, necrotizing autoimmune myositis, antisynthetase syndrome-overlap myositis, and inclusion body myositis. Although polymyositis is no longer considered a distinct subset but rather an extinct entity, it is herein described because its clinicopathologic information has provided over many years fundamental information on T-cell-mediated myocytotoxicity, especially in reference to inclusion body myositis. Each inflammatory myopathy subset has distinct immunopathogenesis, prognosis, and response to immunotherapies, necessitating the need to correctly diagnose each subtype from the outset and avoid disease mimics. The paper describes the main clinical characteristics that aid in the diagnosis of each myositis subtype, highlights the distinct features on muscle morphology and immunopathology, elaborates on the potential role of autoantibodies in pathogenesis or diagnosis , and clarifies common uncertainties in reference to putative triggering factors such as statins and viruses including the 2019-coronavirus-2 pandemic. It extensively describes the main autoimmune markers related to autoinvasive myocytotoxic T-cells, activated B-cells, complement, cytokines, and the possible role of innate immunity. The concomitant myodegenerative features seen in inclusion body myositis along with their interrelationship between inflammation and degeneration are specifically emphasized. Finally, practical guidelines on the best therapeutic approaches are summarized based on up-to-date knowledge and controlled studies, highlighting the prospects of future immunotherapies and ongoing controversies.
(Copyright © 2023 Elsevier B.V. All rights reserved.)

Keywords: Antisynthetase syndrome-overlap myositis; Dermatomyositis; Inclusion body myositis; Necrotizing autoimmune myositis; Polymyositis

0 (Autoantibodies)

Date Created: 20230810 Date Completed: 20230814 Latest Revision: 20230814

20231215

10.1016/B978-0-323-98818-6.00023-6

37562881