Updates on endothelial injury in dermatomyositis: Clinical correlations and potential mechanisms

Dermatomyositis (DM) is a systemic autoimmune disorder with significant heterogeneity. Recent studies have shown that clinical manifestations associated with vascular damage, such as edema, ulcers, severe capillary microcirculation disturbances, and muscle ischemia, are associated with more severe diseases. The risk of cardiovascular diseases in patients with DM is significantly higher than in healthy individuals. Increasing evidence suggests that vascular endothelial cell (EC) injury may occupy a central position in vascular injury in DM and is associated with disease activity. Experimental evidence suggests that EC damage and phenotypic transformation contribute to skin and muscle involvement, as well as pulmonary fibrosis. Further research is needed to elucidate the mechanisms of EC damage, which will help identify more effective biomarkers and develop more targeted therapies.