与肌肉炎相关的间歇性肺病
Trang T T Vu1, Kevin K Brown2, Joshua J Solomon2
1Internal Medicine Department, Hanoi Medical University - Respiratory Center, Bach Mai hospital, Ha Noi, Vietnam.
Current opinion in pulmonary medicine
|July 12, 2023
概括
在异形性炎症性肌肉病 (IIM) 中的间歇性肺病 (ILD) 根据自身抗体配置不同. 抗合成酶综合征和抗MDA5抗体是影响ILD特征和治疗策略的关键亚型.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 免疫学 免疫学 免疫学
背景情况:
- 间歇性肺病 (ILD) 是异常性炎症性肌肉病 (IIM) 的常见并发症,在各大洲的患病率不同.
- 自体抗体配置文件,包括肌肉炎特异性和肌肉炎相关 (MSA和MAA) 抗体,对于预测IIM临床表型和疾病进展至关重要.
研究的目的:
- 本综述侧重于IIM内的ILD亚型的特征和管理,特别是与抗合成酶综合征相关的ILD和抗MDA5抗体阳性ILD.
- 突出IIM中这些流行ILD亚型的临床相关性和独特特征.
主要方法:
- 审查当前关于异形性炎症性肌肉病和相关间歇性肺部疾病的文献.
- 分析自身抗体 (MSA和MAA) 概况及其与临床表型和ILD进展的相关性.
- 对与抗合成酶综合征相关的ILD和抗MDA5阳性ILD的治疗策略的检查.
主要成果:
- 在IIM中,ILD的流行率在亚洲 (50%) 比北美 (23%) 和欧洲 (26%) 高.
- 与抗合成酶综合征相关的ILD呈现,进展和预后因特定的抗ARS抗体 (例如,抗PL-7/抗PL-12与抗Jo-1) 而有所不同.
- 在亚洲人群中,抗MDA5抗体的患病率更高. 抗MDA5阳性ILD经常是快速进展的 (RP-ILD),而抗合成酶综合征可以呈现为慢性惰的ILD.
结论:
- 自体抗体概况显著影响IIM中ILD的临床过程和严重程度.
- 抗合成酶综合征和抗MDA5阳性ILD代表着不同的临床重要亚型,需要量身定制的管理.
- 这些ILD亚型的治疗通常涉及皮质类固醇和其他免疫抑制剂的组合.
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