Zampieri Sandra, Ghirardello Anna, Iaccarino Luca, Briani Chiara, Sarzi-Puttini Piercarlo, Atzeni F, Arienti Silvia, Todesco Silvano, Doria Andrea
University of Padova, Division of Rheumatology, Department of Clinical and Experimental Medicine, Italy.
Autoimmunity. 2006 May;39(3):191-6. doi: 10.1080/08916930600622348.
In genetically predisposed individuals, viruses, bacteria, or parasitic infectious agents are suspected to induce autoimmunity and/or to exacerbate the disease once the self-tolerance is broken. Although direct evidence for this association is still lacking, numerous data from animal models as well as from humans support the hypothesis of a direct contribution of pathogens to the induction of several autoimmune diseases. This review focused on the possible role of infectious agents as triggers of autoimmunity in polymyositis (PM) and dermatomyositis (DM). Epidemiological studies, clinical and experimental findings that support the hypothesis of infection-induced PM and DM are summarized and discussed. In addition, immune response abnormalities and immunosuppressive medications may be responsible for the high percentage of infectious complications in PM and DM patients. In this review, the increased risk of developing infections in these patients is also underlined and published data are reported.
在具有遗传易感性的个体中，一旦自身耐受性被打破，病毒、细菌或寄生虫感染因子被怀疑会诱发自身免疫和/或加剧疾病。尽管仍缺乏这种关联的直接证据，但来自动物模型以及人类的大量数据支持病原体对几种自身免疫性疾病的诱发有直接作用这一假说。本综述聚焦于感染因子作为多发性肌炎（PM）和皮肌炎（DM）中自身免疫触发因素的可能作用。总结并讨论了支持感染诱发PM和DM这一假说的流行病学研究、临床和实验结果。此外，免疫反应异常和免疫抑制药物可能是PM和DM患者感染并发症发生率高的原因。在本综述中，还强调了这些患者发生感染的风险增加，并报告了已发表的数据。
