Myositis in mixed connective tissue disease: a unique syndrome characterized by immunohistopathologic elements of both polymyositis and dermatomyositis.
| Autor: | Vianna MA; Division of Rheumatology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil., Borges CT, Borba EF, Caleiro MT, Bonfá E, Marie SK |
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| Jazyk: | angličtina |
| Zdroj: | Arquivos de neuro-psiquiatria [Arq Neuropsiquiatr] 2004 Dec; Vol. 62 (4), pp. 923-34. Date of Electronic Publication: 2004 Dec 15. |
| DOI: | 10.1590/s0004-282x2004000600001 |
| Abstrakt: | Objective: To characterize the inflammatory cells, the expression pattern of adhesion molecules (ICAM-1 and VCAM-1), membrane attack complex (C5b-9), and major histocompatibility complex (MHC) antigens in muscle biopsy of mixed connective tissue disease (MCTD). Method: We studied 14 patients with MCTD, and compared to 8 polimyositis (PM) patients, 5 dermatomyositis (DM) and 4 dystrophies. Inflammatory cells were examined for CD4+, CD8+, memory and naive T cells, natural killer cells, and macrophages. Expression of MHC-I and -II, ICAM-1, VCAM-1 and C5b -9 were characterized on muscle fibers and vessels. Results: Morphological analysis displayed a pattern of PM. Immunohistochemical study revealed a decreased number of capillaries, predominance of CD4+ and B cells in perivascular regions and predominance of CD8+ and CD45RO+ in endomysial regions. The expression of MHC-I on vessels and on degenerated muscle fibers, MHC-II expression on vessels and perifascicular muscle fibers, and the expression of ICAM-1 / VCAM-1 on endothelial cells indicated both vascular and cellular-immune mediated processes causing the muscular lesion. Conclusion: Our findings revealed a mixed mechanism in MCTD, both vascular involvement as DM, and cell-mediated like PM. |
| Databáze: | MEDLINE |
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