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Neurology 2002;58:1779-1785
© 2002 American Academy of Neurology

Differential expression of chemokines in inflammatory myopathies

Jan L. De Bleecker, MD, PhD, Boel De Paepe, MSc, Iris E. Vanwalleghem, MD and J. Michael Schröder, MD, PhD

From the Department of Neurology (Drs. De Bleecker and Vanwalleghem, and B. De Paepe), University Hospital, Gent, Belgium; and Institut für Neuropathologie (Dr. Schröder), Universitätsklinikum der Rheinisch-Westphälischen Hochschule Aachen, Aachen, Germany.

Address correspondence and reprint requests to Dr. J.L. De Bleecker, University Hospital, Department of Neurology, De Pintelaan 185, B-9000 Gent, Belgium; e-mail: jan.debleecker{at}rug.ac.be

Background: Chemokines represent a family of small-molecular-weight cytokines that recruit and activate inflammatory cells in response to inflammation. Invasion of cytotoxic memory T cells and macrophages in nonnecrotic muscle fibers characterizes polymyositis and sporadic inclusion body myositis. Dermatomyositis is a complement-mediated endotheliopathy. Elucidation of the mechanisms guiding lymphocyte diapedesis and trafficking could lead to selective therapeutic interventions.

Methods: Immunoblots and multistep immunofluorescence studies with non–cross-reactive antibodies recognizing interleukin-8, monocyte chemoattractant protein-1 (MCP-1), MCP-3, TARC (thymus and activation regulated cytokine), and RANTES (regulated upon activation, normal T-cell expressed and secreted), using appropriate positive and negative controls. In situ hybridization was used to localize MCP-1 mRNA.

Results: MCP-1 protein was strongly expressed on T cells and a subset of macrophages actively invading a proportion of the nonnecrotic muscle fibers in polymyositis and inclusion body myositis alike. Capillaries and arterioles in the vicinity of endomysial inflammatory foci were immunoreactive for MCP-1, with faint or no expression in unaffected parts of the tissue. By contrast, widespread and strong endothelial MCP-1 expression occurred on perifascicular and perimysial endothelia in dermatomyositis, also at sites remote from inflammatory infiltrates. In some control specimens, a subset of capillaries also expressed MCP-1, possibly reflecting a role of this chemokine in normal immune surveillance. MCP-1 mRNA was detected in scattered macrophages in each inflammatory myopathy. All other chemokines were absent.

Conclusion: Chemokines are differentially expressed in the symptomatic stage of inflammatory myopathies. MCP-1 plays a major role in the myocytotoxicity in polymyositis and inclusion body myositis. MCP-1 may be induced by membranolytic attack complex binding to endothelial cells in dermatomyositis.




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