Journal of Leukocyte Biology: An Official Publication of the Reticuloendothelial Society | |
Infections and autoimmunity: the multifaceted relationship | |
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...
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