Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA.
Curr Opin Rheumatol. 2012 Jul;24(4):383-8. doi: 10.1097/BOR.0b013e3283535801.
Systemic lupus erythematosus (SLE) is a heterogeneous human disease influenced by a complex interplay of necessary, but not individually sufficient, factors. Although many genetic and environmental factors are associated with SLE, this review will focus on the evolving evidence for key Epstein-Barr virus (EBV)-specific roles in SLE, focusing on new experimental studies published during 2009, 2010, and 2011.
SLE patients have a dysregulated immune response against EBV. EBV antigens exhibit structural molecular mimicry with common SLE antigens and functional molecular mimicry with critical immune-regulatory components. SLE patients, from a number of unique geographic regions, are shown to have higher rates of EBV seroconversion, especially against early EBV antigens, suggesting frequent viral reactivation. SLE patients also have increased EBV viral loads and impaired EBV-specific CD8 cytotoxic T cells, with impaired cytokine responses to EBV in lupus patients. Irregular cytokine production in plasmacytoid dendritic cells and CD69 CD4 T cells after stimulation with EBV has also been demonstrated.
Recent advances demonstrate SLE-specific serologic responses, gene expression, viral load, T-cell responses, humoral fine specificity, and molecular mimicry with EBV, further supporting potential roles for EBV in lupus etiology and pathogenesis.
系统性红斑狼疮（SLE）是一种异质性人类疾病，受多种必要但非单独充分的因素相互作用的影响。尽管许多遗传和环境因素与 SLE 相关，但本篇综述将重点关注 2009 年、2010 年和 2011 年期间发表的新实验研究中，关于 EBV 特异性在 SLE 中关键作用的不断发展的证据。
SLE 患者存在针对 EBV 的失调免疫反应。EBV 抗原与常见的 SLE 抗原具有结构分子模拟性，与关键免疫调节成分具有功能分子模拟性。来自多个独特地理区域的 SLE 患者显示 EBV 血清转化率更高，尤其是针对早期 EBV 抗原，提示频繁的病毒再激活。SLE 患者还具有更高的 EBV 病毒载量和受损的 EBV 特异性 CD8 细胞毒性 T 细胞，对狼疮患者的 EBV 反应存在受损的细胞因子应答。此外，还已经证明在受到 EBV 刺激后，浆细胞样树突状细胞和 CD69+CD4+T 细胞中的不规则细胞因子产生。
最近的进展表明了 SLE 特异性的血清学反应、基因表达、病毒载量、T 细胞反应、体液精细特异性和 EBV 分子模拟性，进一步支持 EBV 在狼疮病因和发病机制中的潜在作用。
