| Budget Amount *help |
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 2006: ¥1,600,000 (Direct Cost: ¥1,600,000)
Fiscal Year 2005: ¥1,800,000 (Direct Cost: ¥1,800,000)
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| Research Abstract |
This project aimed to propose new diagnostic criteria for myositis based on clinical and pathological findings. Firstly we analyzed the frequency of diagnostic clinical and pathological findings for myositis in biopsied muscles from 126 consecutive cases with PM/DM. We found that the immunohistochemical findings of aberrant expression of MHC-I antigen on non-necrotic fibers are frequent and are good marker for detecting inflammatory changes even with sparse inflammatory cells. We also found that the findings of the invasion of CD8 positive lymphocytes into non-necrotic fibers, which findings are specific for polymyositis are about 5%, and the frequency of the findings of perifascicular atrophy and the deposition of complement complexes on endomysial capillaries are 13% and 23% respectively. Ultrastrucural observation showed that the findings of tuburoreticular profiles in endothelial cells and destruction of endomysial capillaries are other good markers for diagnosis of dermatomyositis. The multifactor analysis between clinical and pathological factors did not show correlation between clinical and pathological findings. Following above results, we proposed a new diagnostic criterion based on skin changes and immunohistochemical and ultrastructural pathological findings in biopsied muscle. The validity of the new criteria was assessed through analyzing clinical pictures of consecutive 187 cases with PM/DM. The 187 cases were classified into 10 PM cases (6%), 94DM cases (50%), 62 unclassified myositis cases (33%) and 21 probable myositis cases. It was revealed that the clinical pictures between PM and DM are quite different and the cases with malignancy, collagen disease or pulmonary fibrosis were found only in DM group. The serum cytokine profiles (GM-CSF、 IFN-γ、IL-1b,2,4,5,6,8,10,TNF-a) assessed in 69 PM/DM cases also showed the difference between PM and DM groups. The results supported the validity of the proposed new criteria.
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