Nunes H, Deny P, Raphael M, Valeyre D
Service de pneumologie et réanimation respiratoire, UPRES EA 2705 Maladies vasculaires pulmonaires, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France.
Rev Mal Respir. 2001 Jun;18(3):247-55.
A role for viruses in the development or course of the main idiopathic chronic infiltrative lung disease has been suggested for a long time. Viruses that have usually been incriminated in cryptogenic fibrosing alveolitis are hepatitis C virus, whose role has not been accurately proven, and latent viruses including Epstein-Barr virus and adenovirus. These latent viruses might be re-activated in the lung of patients immunocompromised by treatments and might be accountable for disease progression. However, published studies have been very conflicting and the only clinical trial testing ribavirin has failed to demonstrate a beneficial effect. In sarcoidosis, the responsibility of human herpesvirus 6 and 8 and retroviruses has not been proven. Finally, data in the literature do not support a link between Langerhans cell histiocytosis and human herpesvirus 6 and 8. These viruses may act by several mechanisms: viral proteins may be antigens driving an appropriate immune response; they may also behave as transactivating factors to control the expression of various genes involved in immune response, cell growth or synthesis of matrix proteins.
长期以来,人们一直认为病毒在主要的特发性慢性浸润性肺疾病的发生或病程中起一定作用。通常与隐源性纤维性肺泡炎相关的病毒有丙型肝炎病毒,其作用尚未得到确切证实,还有包括爱泼斯坦 - 巴尔病毒和腺病毒在内的潜伏病毒。这些潜伏病毒可能在因治疗而免疫受损的患者肺部重新激活,并可能导致疾病进展。然而,已发表的研究结果非常矛盾,唯一一项测试利巴韦林的临床试验未能证明其有益效果。在结节病中,人类疱疹病毒6型和8型以及逆转录病毒的作用尚未得到证实。最后,文献中的数据不支持朗格汉斯细胞组织细胞增多症与人类疱疹病毒6型和8型之间存在关联。这些病毒可能通过多种机制起作用:病毒蛋白可能作为驱动适当免疫反应的抗原;它们也可能作为反式激活因子来控制参与免疫反应、细胞生长或基质蛋白合成的各种基因的表达。