Infections and autoimmunity: the multifaceted relationship

Journal of Leukocyte Biology

Margherita Zen¹  Michele Tonon¹  Nicola Bassi¹  Paolo Sfriso¹  Costantino Botsios¹  Anna Ghirardello¹  Franco Bassetto²  Andrea Doria¹ 

[1] Division of Rheumatology, Clinical and Experimental Medicine, and Division of Rheumatology, Clinical and Experimental Medicine, and Division of Rheumatology, Clinical and Experimental Medicine, and;Section of Plastic Surgery, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy Section of Plastic Surgery, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy Section of Plastic Surgery, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy

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 】

Multiple factors are thought to contribute to the development of immune response to self, including differences in genotypes, hormonal milieu, and environmental factors. This review focuses on the pivotal role of infection in the induction of autoimmune disorders. Although the development of autoimmune phenomena linked to infections is a common finding, the onset of autoimmune diseases is a rare event, arising from a combination of genetic susceptibility and environmental factors. There are several mechanisms through which pathogens can initiate or perpetuate autoimmunity. Some of them are antigen-specific, including molecular mimicry, expression of modified, cryptic, or new antigenic determinants, and superantigens. Others are nonspecific and collectively known as “bystander activation.” They include enhanced processing and presentation of self-antigens, immune cell activation, cytokine release, and cell apoptosis/necrosis. Infections may also trigger organ-specific autoimmune diseases, but studies carried out until now have provided conflicting and inconclusive results regarding the role of viral and bacterial agents. Infections and autoimmune diseases have multifaceted and multidirectional relationships. It has been suggested recently that infections cannot only induce or precipitate autoimmune diseases, but they may also protect from autoimmunity or even abrogate an ongoing autoimmune process depending on the interaction between microorganisms and host. Therefore, we should look at microorganisms, not only as causes of infections but also as potential agents able to modulate the immune system. On the other hand, numerous evidences have emerged regarding the higher susceptibility of autoimmune patients to infections, possibly as a result of immunosuppressive therapy and treatment with biologic agents.

【 授权许可】

Unknown