Polymyositis-dermatomyositis and infections.
In genetically predisposed individuals, viruses, bacteria, or parasitic infectious agents are suspected to induce autoimmunity and/or to exacerbate the disease once the self-tolerance is broken. Although direct evidence for this association is still lacking, numerous data from animal models as well as from humans support the hypothesis of a direct contribution of pathogens to the induction of several autoimmune diseases. This review focused on the possible role of infectious agents as triggers of autoimmunity in polymyositis (PM) and dermatomyositis (DM). Epidemiological studies, clinical and experimental findings that support the hypothesis of infection-induced PM and DM are summarized and discussed. In addition, immune response abnormalities and immunosuppressive medications may be responsible for the high percentage of infectious complications in PM and DM patients. In this review, the increased risk of developing infections in these patients is also underlined and published data are reported.
Zampieri
Sandra
S
University of Padova, Division of Rheumatology, Department of Clinical and Experimental Medicine, Italy.
Ghirardello
Anna
A
Iaccarino
Luca
L
Briani
Chiara
C
Sarzi-Puttini
Piercarlo
P
Atzeni
F
F
Arienti
Silvia
S
Todesco
Silvano
S
Doria
Andrea
A
D000818:Animals; D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000209:etiology* / Q000276:immunology; D003882:Dermatomyositis / Q000150:complications / Q000209:etiology* / Q000276:immunology; D004195:Disease Models, Animal; D006801:Humans; D007239:Infections / Q000150:complications* / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D017285:Polymyositis / Q000150:complications / Q000209:etiology* / Q000276:immunology; D017634:Self Tolerance / Q000276:immunology
D001323:Autoantibodies