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Current Opinion in Rheumatology Nov 2018To provide the most recent evidence on the overlap myositis. (Review)
Review
PURPOSE OF REVIEW
To provide the most recent evidence on the overlap myositis.
RECENT FINDINGS
Several new evidences on the overlap myositides have recently emerged. Regarding the classical myositis associated antibodies, several contributions focused on a better definition of the clinical associations and the disease course associated with these autoantibodies. Moreover, in the last years, new autoantibodies in idiopathic inflammatory myositis or other connective tissue diseases have been identified [namely anti-RuvBL1/2, poly-U-binding factor 60 kDa protein (PUF-60) and cytosolic 5'-nucleotidase 1A (NT5C1A)], and an increasing number of publications allow now to consider them as new myositis-associated antibodies with probably their own peculiar clinical profile.
SUMMARY
Overlap myositis is probably the largest subgroup within the idiopathic inflammatory myositis, with a prevalence that can reach 50% of all adult patients. The serological spectrum of overlap myositis has recently been enriched by the discovery of new autoantibodies. The spread of multiparametric methods has facilitated the identification of the autoantibody marker of overlap myositis and the better definition of the clinical profiles associated with them.
Topics: Autoantibodies; Autoimmune Diseases; Biomarkers; Humans; Myositis
PubMed: 30074509
DOI: 10.1097/BOR.0000000000000536 -
Current Opinion in Rheumatology Nov 2023This review provides an overview of the management and treatment landscape of inclusion body myositis (IBM), while highlighting the current challenges and future... (Review)
Review
PURPOSE OF REVIEW
This review provides an overview of the management and treatment landscape of inclusion body myositis (IBM), while highlighting the current challenges and future directions.
RECENT FINDINGS
IBM is a slowly progressive myopathy that predominantly affects patients over the age of 40, leading to increased morbidity and mortality. Unfortunately, a definitive cure for IBM remains elusive. Various clinical trials targeting inflammatory and some of the noninflammatory pathways have failed. The search for effective disease-modifying treatments faces numerous hurdles including variability in presentation, diagnostic challenges, poor understanding of pathogenesis, scarcity of disease models, a lack of validated outcome measures, and challenges related to clinical trial design. Close monitoring of swallowing and respiratory function, adapting an exercise routine, and addressing mobility issues are the mainstay of management at this time.
SUMMARY
Addressing the obstacles encountered by patients with IBM and the medical community presents a multitude of challenges. Effectively surmounting these hurdles requires embracing cutting-edge research strategies aimed at enhancing the management and treatment of IBM, while elevating the quality of life for those affected.
Topics: Humans; Myositis, Inclusion Body; Quality of Life; Myositis
PubMed: 37503813
DOI: 10.1097/BOR.0000000000000958 -
CMAJ : Canadian Medical Association... Apr 2024
Topics: Humans; Myositis, Inclusion Body; Myositis
PubMed: 38621777
DOI: 10.1503/cmaj.231815 -
The Lancet. Neurology Sep 2018Inflammatory myopathies, collectively known as myositis, are heterogeneous disorders characterised by muscle inflammation, and frequently accompanied by extramuscular... (Review)
Review
Inflammatory myopathies, collectively known as myositis, are heterogeneous disorders characterised by muscle inflammation, and frequently accompanied by extramuscular manifestations that affect the skin, lung, and joints. Patients with inflammatory myopathies were previously classified as having dermatomyositis if characteristic rashes accompanied the muscle involvement, and as having polymyositis if no rashes were present. Five main types of inflammatory myopathies are now widely recognised: dermatomyositis, immune-mediated necrotising myopathy, sporadic inclusion-body myositis, overlap myositis (including antisynthetase syndrome), and polymyositis. The discovery of autoantibodies that are specifically associated with characteristic clinical phenotypes has been instrumental to the understanding of inflammatory myopathies. Treatment is still largely based on expert opinion, but several studies have shown effectiveness of different therapies in various subsets of inflammatory myopathies. These advances will undoubtedly improve the outcomes of patients with inflammatory myopathies.
Topics: Adult; Disease Management; Humans; Myositis
PubMed: 30129477
DOI: 10.1016/S1474-4422(18)30254-0 -
Handbook of Clinical Neurology 2023The autoimmune inflammatory myopathies constitute a heterogeneous group of acquired myopathies that have in common the presence of endomysial inflammation and moderate... (Review)
Review
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.
Topics: Humans; Myositis, Inclusion Body; COVID-19; Myositis; Autoimmune Diseases; Inflammation; Autoantibodies
PubMed: 37562881
DOI: 10.1016/B978-0-323-98818-6.00023-6 -
Current Opinion in Rheumatology Nov 2004Defined autoantibodies are found in about half of the patients with myositis. Traditionally, these autoantibodies have been divided into myositis specific autoantibodies... (Review)
Review
PURPOSE OF REVIEW
Defined autoantibodies are found in about half of the patients with myositis. Traditionally, these autoantibodies have been divided into myositis specific autoantibodies (MSAs) and myositis associated autoantibodies. Several studies have shown that MSAs are associated with specific clinical characteristics and can aid our understanding of the pathophysiology of myositis.
RECENT FINDINGS
Recent studies suggest that some MSAs are markers of specific inflammatory muscle diseases (e.g., anti-SRP for an immune-mediated necrotizing myopathy) and not just of myositis in general. Furthermore, new insights are emerging about the pathophysiology of MSAs, in particular anti-Jo-1. Based on these new insights, an alternative hypothesis of the formation of anti-Jo-1 autoantibodies is presented in which the immune system itself rather than muscle is the site of antigen presentation.
SUMMARY
The recognition that some MSAs are markers of specific disease entities that were once commonly referred to as (poly)myositis, aids the development of better disease definitions. The changing insights in the function of the Jo-1 antigen and the emergence of new hypotheses on the formation of the Jo-1 antibody, open new avenues for future research aimed at unraveling the mystery of myositis.
Topics: Antibody Specificity; Autoantibodies; Humans; Myositis
PubMed: 15577606
DOI: No ID Found -
Duodecim; Laaketieteellinen... 1979
Review
Topics: Bacterial Infections; Biopsy; Creatine Kinase; Electromyography; Humans; Muscles; Myositis; Neoplasms; Parasitic Diseases; Sarcoidosis; Virus Diseases
PubMed: 393485
DOI: No ID Found -
Rheumatology (Oxford, England) May 2010
Topics: Diagnosis, Differential; Humans; Immunosuppressive Agents; Myositis; Steroids
PubMed: 20040531
DOI: 10.1093/rheumatology/kep355 -
Chest Jul 2020Idiopathic inflammatory myopathies are autoimmune processes that are characterized by skeletal muscle inflammation. The lung is the most commonly involved extramuscular... (Review)
Review
Idiopathic inflammatory myopathies are autoimmune processes that are characterized by skeletal muscle inflammation. The lung is the most commonly involved extramuscular organ, and, when present, pulmonary disease drives morbidity and mortality. A subset of patients can present with rapidly progressive hypoxemic respiratory failure due to myositis-related interstitial lung disease. Confirmatory autoantibody testing requires sending samples to a reference laboratory; thus, diagnosis of rapidly progressive myositis-associated interstitial lung disease relies on a high index of suspicion and careful history and physical examination. Although the cornerstone of therapy for these patients remains multimodality immunosuppression, emerging data support a role for advanced therapies (including extracorporeal membrane oxygenation and lung transplantation) in appropriately selected patients. It is hoped that greater awareness of the clinical features of this syndrome will allow for appropriate diagnosis and treatment of these potentially treatable patients, as well as raise awareness of the need for multicenter collaboration to prospectively study how to manage this complex disease.
Topics: Humans; Lung Diseases, Interstitial; Myositis
PubMed: 32059958
DOI: 10.1016/j.chest.2020.01.033 -
Current Opinion in Rheumatology Nov 2004The etiology and much about the pathogenesis of the inflammatory myopathies remain a mystery. In this review, we investigate recent research efforts to understand the... (Review)
Review
PURPOSE OF REVIEW
The etiology and much about the pathogenesis of the inflammatory myopathies remain a mystery. In this review, we investigate recent research efforts to understand the pathogenesis of the diverse entities of polymyositis (PM), dermatomyositis (DM), and inclusion body myositis (IBM), diseases that result from interactions between environmental risk factors and genetic susceptibility.
RECENT FINDINGS
Over the past year, there has been considerable progress toward better understanding of IBM, with relatively few developments toward understanding PM and DM. Although these diseases may share some common clinical phenotypic and serologic components, they differ on a molecular and cellular level.
SUMMARY
The need for definitive, safer therapies in these diseases makes vital the search for defining detailed pathogenesis of inflammation and muscle fiber damage at the molecular level.
Topics: Animals; Humans; Myositis; Risk Factors
PubMed: 15577607
DOI: 10.1097/01.bor.0000141925.21941.d8