Selected aspects of the current management of myositis

Lilleker, James B; Murphy, Sean M.; Cooper, Robert G.

doi:10.1177/1759720x16655126

Cited by 8 publications

(7 citation statements)

References 50 publications

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“…RELMα and RELMβ are also involved in other vascular diseases. Idiopathic inflammatory myopathies are a rare and heterogeneous group of acquired autoimmune muscle disorders [ 104 ]. High levels of serum IL-18 have been observed in patients with inflammatory myopathy [ 105 ].…”

Section: Relms Are Involved In Multiple Diseasesmentioning

confidence: 99%

Resistin-like molecules: a marker, mediator and therapeutic target for multiple diseases

et al. 2023

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Resistin-like molecules (RELMs) are highly cysteine-rich proteins, including RELMα, RELMβ, Resistin, and RELMγ. However, RELMs exhibit significant differences in structure, distribution, and function. The expression of RELMs is regulated by various signaling molecules, such as IL-4, IL-13, and their receptors. In addition, RELMs can mediate numerous signaling pathways, including HMGB1/RAGE, IL-4/IL-4Rα, PI3K/Akt/mTOR signaling pathways, and so on. RELMs proteins are involved in wide range of physiological and pathological processes, including inflammatory response, cell proliferation, glucose metabolism, barrier defense, etc., and participate in the progression of numerous diseases such as lung diseases, intestinal diseases, cardiovascular diseases, and cancers. Meanwhile, RELMs can serve as biomarkers, risk predictors, and therapeutic targets for these diseases. An in-depth understanding of the role of RELMs may provide novel targets or strategies for the treatment and prevention of related diseases.

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Section: Relms Are Involved In Multiple Diseasesmentioning

confidence: 99%

Resistin-like molecules: a marker, mediator and therapeutic target for multiple diseases

et al. 2023

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“… 3 The rarity and heterogeneity of IIM has hampered research efforts and impeded the delivery of large-scale interventional clinical trials. 4 Consequently, the therapeutic evidence-base in IIM is remarkably limited. 5 6 Recently, several IIM research databases and registries have been created to pool resources and expertise, facilitating completion of several international IIM research studies.…”

Section: Introductionmentioning

confidence: 99%

The EuroMyositis registry: an international collaborative tool to facilitate myositis research

et al. 2017

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AimsThe EuroMyositis Registry facilitates collaboration across the idiopathic inflammatory myopathy (IIM) research community. This inaugural report examines pooled Registry data.MethodsCross-sectional analysis of IIM cases from 11 countries was performed. Associations between clinical subtypes, extramuscular involvement, environmental exposures and medications were investigated.ResultsOf 3067 IIM cases, 69% were female. The most common IIM subtype was dermatomyositis (DM) (31%). Smoking was more frequent in connective tissue disease overlap cases (45%, OR 1.44, 95% CI 1.09 to 1.90, p=0.012). Smoking was associated with interstitial lung disease (ILD) (OR 1.32, 95% CI 1.06 to 1.65, p=0.013), dysphagia (OR 1.43, 95% CI 1.16 to 1.77, p=0.001), malignancy ever (OR 1.78, 95% CI 1.36 to 2.33, p<0.001) and cardiac involvement (OR 2.40, 95% CI 1.60 to 3.60, p<0.001).Dysphagia occurred in 39% and cardiac involvement in 9%; either occurrence was associated with higher Health Assessment Questionnaire (HAQ) scores (adjusted OR 1.79, 95% CI 1.43 to 2.23, p<0.001). HAQ scores were also higher in inclusion body myositis cases (adjusted OR 3.85, 95% CI 2.52 to 5.90, p<0.001). Malignancy (ever) occurred in 13%, most commonly in DM (20%, OR 2.06, 95% CI 1.65 to 2.57, p<0.001).ILD occurred in 30%, most frequently in antisynthetase syndrome (71%, OR 10.7, 95% CI 8.6 to 13.4, p<0.001). Rash characteristics differed between adult-onset and juvenile-onset DM cases (‘V’ sign: 56% DM vs 16% juvenile-DM, OR 0.16, 95% CI 0.07 to 0.36, p<0.001). Glucocorticoids were used in 98% of cases, methotrexate in 71% and azathioprine in 51%.ConclusionThis large multicentre cohort demonstrates the importance of extramuscular involvement in patients with IIM, its association with smoking and its influence on disease severity. Our findings emphasise that IIM is a multisystem inflammatory disease and will help inform prognosis and clinical management of patients.

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“…In affected muscles, edematous and necrotic myofibers will cause a swelling of the extracellular volume and an increase in ADC and MD values. Research shows that membrane attack complex (MAC) is inclined to deposit endomysium capillaries within the affected muscle, and with a subsequent relative reduction in capillary density, thus muscle tissue may be ischemia and infarcts nearby (2,16). In the early stages of the disease, this ischemic microangiopathy may induce tissue hyper-perfusion, increasing ADC value followed by extracellular water content.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic value of T2 map, diffusion tensor imaging, and diffusion kurtosis imaging in differentiating dermatomyositis from muscular dystrophy

et al. 2021

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Background Dermatomyositis (DM) and muscular dystrophy are clinically difficult to differentiate. Purpose To confirm the feasibility and assess the accuracy of conventional magnetic resonance imaging (MRI), T2 map, diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI) in the differentiation of DM from muscular dystrophy. Material and Methods Forty-two patients with DM proven by diagnostic criteria were enrolled in the study along with 23 patients with muscular dystrophy. Conventional MR, T2 map, DTI, and DKI images were obtained in the thigh musculature for all patients. Intramuscular T2 value, apparent diffusion coefficient (ADC), fractional anisotropy (FA), mean diffusivity (MD), and mean kurtosis (MK) values were compared between the patients with DM and muscular dystrophy. Student’s t-tests and receiver operating characteristic (ROC) curve analyses were performed for all parameters. P values < 0.05 were considered statistically significant. Results The intramuscular T2, ADC, FA, MD, and MK values within muscles were statistically significantly different between the DM and muscular dystrophy groups ( P<0.01). The MK value was statistically significantly different between the groups in comparison with T2 and FA value. As a supplement to conventional MRI, the parameters of MD and MK differentiated DM and muscular dystrophy may be valuable. The optimal cut-off value of ADC and MD values (with respective AUC, sensitivity, and specificity) between DM and muscular dystrophy were 1.698 ×10−3mm2/s (0.723, 54.1%, and 78.1%) and 1.80 ×10−3mm2/s (61.9% and 70.2%), respectively. Conclusion Thigh muscle ADC and MD parameters may be useful in differentiating patients with DM from those with muscular dystrophy.

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Selected aspects of the current management of myositis

Cited by 8 publications

References 50 publications

Resistin-like molecules: a marker, mediator and therapeutic target for multiple diseases

Resistin-like molecules: a marker, mediator and therapeutic target for multiple diseases

The EuroMyositis registry: an international collaborative tool to facilitate myositis research

The diagnostic value of T2 map, diffusion tensor imaging, and diffusion kurtosis imaging in differentiating dermatomyositis from muscular dystrophy

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