【分　 类】 医药卫生
【关 键 词】 特发性炎性肌病，细胞因子，研究进展，综述
【来 　源】 互联网
【收　 录】 中文学术期刊网

正文：

5.热休克蛋白（Heat shock proteins,HSP）
热休克蛋白家族包括HSP60、HSP70、HSP90等，具有多种免疫学功能，在细胞免疫与体液免疫中发挥作用，其制剂产品能刺激TNF-α、IL1、IL-12等细胞因子生成，促进单核/巨噬细胞、NK细胞产生NO与趋化因子 [25,26]。HSP65、HSP70、HSP90在特发性炎性肌病中有表达，Boel De Paepe等研究发现HSP90和HSP70的比例与特发性炎性肌病炎症的严重程度成正相关[27], Boel De Paepe进一步研究表明HSP90和HSP70在特发性炎性肌病肌内血管中增加，通过有选择性的招募免疫细胞在特发性炎性肌病肌内血管积极发挥持续炎症反应，另一方面，炎症细胞可以差异性的表达HSP70和HSP90，随着肌纤维活性的降低，在DM患者中HSP90和HSP70表达较低，而在以巨噬细胞和T细胞浸润PM患者中则表达较高。并预测HSP90可以成为特发性炎性肌病的一个潜在的治疗靶点[28]。
6.血清抵抗素（Resistin）
血清抵抗素，又名脂肪细胞分泌因子（adipocyte-secreted factor，ADSF）或炎症区3（fizz3），是脂肪因子家族中的一员。起初，在研究脂肪细胞在小鼠体内诱导的胰岛素抵抗发现了抵抗素，它不仅与多种代谢性疾病相关，而且与肿瘤、炎症和自身免疫性疾病存在一定的关系[29]。抵抗素是上调外周血单个核细胞（PBMC）和诱导炎症介质表达的促炎细胞因子，如白细胞介素（IL）6，IL-8，单核细胞趋化蛋白（MCP）- 1和肿瘤坏死因子（TNF）-α，血管生成因子和细胞外基质金属蛋白酶[30]。Mária Filková通过对42例炎性肌病患者（PM/DM）和27例健康人的血清对比研究发现，在炎性肌病患者中，血清抵抗素水平显著高于对照组，且与C反应蛋白正相关，在Jo-1抗体阳性的患者中，血清抵抗素与肌红蛋白密切相关；皮肌炎患者中，血清抵抗素与肌酸激酶、肌红蛋白正相关。并且发现血清抵抗素在单核细胞可以诱导IL-1b、IL-6和单核细胞趋化蛋白（MCP-1）的表达，而不是之前认为的肌细胞。其研究表明血清抵抗素与皮肌炎疾病的炎症严重程度及肌酶水平密切相关。血清抵抗素通过单核细胞诱导炎性细胞因子的表达间接参与炎性肌病肌肉组织的破坏。提示血清抵抗素在炎性肌病的发病过程中具有重要作用[31]。
小结
综上所述，由于不同患者临床表现的不同，导致其免疫系统的紊乱机制也不尽相同。各种细胞因子在炎性性疾病中都不是孤军奋战，每一种细胞因子都具有多种生物学活性，因此其在疾病的发生发展过程中相互影响、相互促进/抑制的作用。然而，特发性炎性肌病的发病机制是十分复发的，这就说明我们需要进一步的进行研究IIM相关细胞因子发生发展的机制、临床意义及相互作用，有利于加深对IIM的认识、指导临床诊疗以及判断预后。
 
 
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