Infections and autoimmunity: the multifaceted relationship

Journal of Leukocyte Biology: An Official Publication of the Reticuloendothelial Society

关键词: autoimmune diseases;    molecular mimicry;    bystander activation;    self‐;    tolerance loss;    immunosuppressive therapy;    biologic agents;   

DOI  :  10.1189/jlb.0709517

学科分类：生理学

来源: Federation of American Societies for Experimental Biology

【 摘 要 】

Multiplefactorsarethoughttocontributetothedevelopmentofimmuneresponsetoself,includingdifferencesingenotypes,hormonalmilieu,andenvironmentalfactors.Thisreviewfocusesonthepivotalroleofinfectionintheinductionofautoimmunedisorders.Althoughthedevelopmentofautoimmunephenomenalinkedtoinfectionsisacommonfinding,theonsetofautoimmunediseasesisarareevent,arisingfromacombinationofgeneticsusceptibilityandenvironmentalfactors.Thereareseveralmechanismsthroughwhichpathogenscaninitiateorperpetuateautoimmunity.Someofthemareantigen‐specific,includingmolecularmimicry,expressionofmodified,cryptic,ornewantigenicdeterminants,andsuperantigens.Othersarenonspecificandcollectivelyknownas“bystanderactivation.”Theyincludeenhancedprocessingandpresentationofself‐antigens,immunecellactivation,cytokinerelease,andcellapoptosis/necrosis.Infectionsmayalsotriggerorgan‐specificautoimmunediseases,butstudiescarriedoutuntilnowhaveprovidedconflictingandinconclusiveresultsregardingtheroleofviralandbacterialagents.Infectionsandautoimmunediseaseshavemultifacetedandmultidirectionalrelationships.Ithasbeensuggestedrecentlythatinfectionscannotonlyinduceorprecipitateautoimmunediseases,buttheymayalsoprotectfromautoimmunityorevenabrogateanongoingautoimmuneprocessdependingontheinteractionbetweenmicroorganismsandhost.Therefore,weshouldlookatmicroorganisms,notonlyascausesofinfectionsbutalsoaspotentialagentsabletomodulatetheimmunesystem.Ontheotherhand,numerousevidenceshaveemergedregardingthehighersusceptibilityofautoimmunepatientstoinfections,possiblyasaresultofimmunosuppressivetherapyandtreatmentwithbiologicagents...

【 授权许可】

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