Risk Factors and Disease Mechanisms in Myositis

Overview

Journal Nat Rev Rheumatol

Specialty Rheumatology

Date 2018 Apr 21

PMID 29674613

Citations 73

Authors

Frederick W Miller

Janine A Lamb

Jens Schmidt

Kanneboyina Nagaraju

Affiliations

Soon will be listed here.

Abstract

Autoimmune diseases develop as a result of chronic inflammation owing to interactions between genes and the environment. However, the mechanisms by which autoimmune diseases evolve remain poorly understood. Newly discovered risk factors and pathogenic processes in the various idiopathic inflammatory myopathy (IIM) phenotypes (known collectively as myositis) have illuminated innovative approaches for understanding these diseases. The HLA 8.1 ancestral haplotype is a key risk factor for major IIM phenotypes in some populations, and several genetic variants associated with other autoimmune diseases have been identified as IIM risk factors. Environmental risk factors are less well studied than genetic factors but might include viruses, bacteria, ultraviolet radiation, smoking, occupational and perinatal exposures and a growing list of drugs (including biologic agents) and dietary supplements. Disease mechanisms vary by phenotype, with evidence of shared innate and adaptive immune and metabolic pathways in some phenotypes but unique pathways in others. The heterogeneity and rarity of the IIMs make advancements in diagnosis and treatment cumbersome. Novel approaches, better-defined phenotypes, and international, multidisciplinary consensus have contributed to progress, and it is hoped that these methods will eventually enable therapeutic intervention before the onset or major progression of disease. In the future, preemptive strategies for IIM management might be possible.

Citing Articles

Occupational dust and chemical exposures and the development of autoimmune rheumatic diseases.

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A window into intracellular events in myositis through subcellular proteomics.

Peterson J, Leclair V, Oyebode O, Herzallah D, Nestor-Kalinoski A, Morais J Inflamm Res. 2025; 74(1):31.

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Increased Risk of Myositis-Specific and Myositis-Associated Autoantibodies After COVID-19 Pandemic and Vaccination: A Spanish Multicenter Collaborative Study.

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Macrophage involvement in idiopathic inflammatory myopathy: pathogenic mechanisms and therapeutic prospects.

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