Autoimmune myopathies: autoantibodies, phenotypes and pathogenesis

Nat Rev Neurol. 2011 Jun 8;7(6):343-54. doi: 10.1038/nrneurol.2011.63.

Abstract

The different autoimmune myopathies-for example, dermatomyositis, polymyositis, and immune-mediated necrotizing myopathies (IMNM)-have unique muscle biopsy findings, but they also share specific clinical features, such as proximal muscle weakness and elevated serum levels of muscle enzymes. Furthermore, around 60% of patients with autoimmune myopathy have been shown to have a myositis-specific autoantibody, each of which is associated with a distinct clinical phenotype. The typical clinical presentations of the autoimmune myopathies are reviewed here, and the different myositis-specific autoantibodies, including the anti-synthetase antibodies, dermatomyositis-associated antibodies, and IMNM-associated antibodies, are discussed in detail. This Review also focuses on a newly recognized form of IMNM that is associated with statin use and the production of autoantibodies that recognize 3-hydroxy-3-methylglutaryl-coenzyme A reductase, the pharmacological target of statins. The contribution of interferon signaling to the development of dermatomyositis and the potential link between malignancies and the initiation of autoimmune myopathies are also assessed.

Publication types

  • Review

MeSH terms

  • Autoantibodies / analysis
  • Autoantibodies / genetics
  • Autoantibodies / immunology*
  • Autoimmune Diseases / genetics
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / pathology*
  • Biopsy
  • Dermatomyositis / immunology
  • Dermatomyositis / pathology
  • Electromyography
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects
  • Ligases / immunology
  • Magnetic Resonance Imaging
  • Muscle Weakness / etiology
  • Muscle Weakness / pathology
  • Muscle, Skeletal / enzymology
  • Muscle, Skeletal / pathology
  • Muscular Diseases / immunology*
  • Muscular Diseases / pathology*
  • Myositis / pathology
  • Neoplasms / epidemiology
  • Phenotype
  • Risk

Substances

  • Autoantibodies
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Ligases