A variety of specific autoantibodies may be present in some patients with DM or PM, implicating the immune system in their pathogenesis. In DM, humoral immune mechanisms may be particularly important, given the predilection for inflammatory cellular infiltration in nonnecrotic muscle fibers and around blood vessels. Vasculopathy can be a particularly prominent feature of childhood disease, with deposition of immunoglobulins and complement components in blood vessels sometimes making skin biopsy specimens indistinguishable from those found in SLE patients. In PM, cell-mediated antigen-specific cytotoxicity appears to be more in pathogenesis, since increased expression of major histocompatibility class I molecules and increased numbers of T cells are found in the muscle in this disorder.
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