Expression of tumor necrosis factor-alpha in muscles of polymyositis.

We immunohistochemically examined biopsied muscles from nine untreated patients with polymyositis (PM) and five patients with other neuromuscular diseases (ONMD), using monoclonal antibodies to tumor necrosis factor-alpha (TNF-alpha) and lymphoid surface markers. In muscles of three patients with PM, we observed many TNF-alpha positive macrophages and lymphocytes in endomysium and around vessels in the muscles. By contrast, there were few, weakly TNF-alpha stained cells in muscles of three patients with ONMD. The ratio of TNF-alpha-positive cells to the muscle fibers and the ratio of TNF-alpha-positive cells to the mononuclear cells were significantly higher in PM compared with ONMD. In addition, we observed atrophic muscle fibers more frequently in TNF-alpha-positive muscles than TNF-alpha-negative ones. We conclude that, at least, in a part of PM patients, TNF-alpha produced locally may contribute to the pathogenesis of PM.