Barzilai Ori, Ram Maya, Shoenfeld Yehuda
Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Israel.
Curr Opin Rheumatol. 2007 Nov;19(6):636-43. doi: 10.1097/BOR.0b013e3282f0ad25.
To review the current literature and summarize the main principles found between viral infections and the subsequent production of autoantibodies.
We concentrate on recent findings involving three viral agents, one of which is Epstein-Barr virus, which has been associated with many autoimmune diseases and is classically considered to induce systemic lupus erythematosus. As we will discuss, this occurs through molecular mimicry between Epstein-Barr virus nuclear antigen 1 and lupus-specific antigens such as Ro, La or dsDNA, through induction of Toll-like receptor hypersensitivity by Epstein-Barr virus latent membrane protein 2A or by creating immortal B and T cells by loss of apoptosis. Hepatitis B virus was found to share amino acid sequences with different autoantigens. Tissue damage and the release of intracellular components is just another example of the autoantibody production caused by this virus. Cytomegalovirus has often been controversially associated with several autoimmune diseases and, although is the least understood viral infection of the three, appears to be somewhat suspicious.
Understanding the infectious origin of autoimmune diseases is important as we aim to identify high-risk patients and disrupt this process with vaccines or other medications, ultimately delaying or even preventing the evolution of autoimmune diseases.
回顾当前文献,总结病毒感染与随后自身抗体产生之间的主要原理。
我们重点关注涉及三种病毒病原体的最新发现,其中之一是爱泼斯坦-巴尔病毒,它与许多自身免疫性疾病有关,传统上被认为可诱发系统性红斑狼疮。正如我们将讨论的,这是通过爱泼斯坦-巴尔病毒核抗原1与狼疮特异性抗原(如Ro、La或双链DNA)之间的分子模拟,通过爱泼斯坦-巴尔病毒潜伏膜蛋白2A诱导Toll样受体超敏反应,或通过细胞凋亡丧失产生永生B细胞和T细胞来实现的。发现乙型肝炎病毒与不同的自身抗原具有相同的氨基酸序列。组织损伤和细胞内成分的释放只是该病毒引起自身抗体产生的另一个例子。巨细胞病毒经常与几种自身免疫性疾病存在争议性关联,尽管它是这三种病毒感染中了解最少的,但似乎也有些可疑。
了解自身免疫性疾病的感染起源很重要,因为我们旨在识别高危患者,并通过疫苗或其他药物干扰这一过程,最终延缓甚至预防自身免疫性疾病的发展。