Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy.
Clin Rev Allergy Immunol. 2013 Aug;45(1):87-96. doi: 10.1007/s12016-012-8343-x.
The sense of smell is an ancient sensory modality vital for sampling and perceiving the chemical composition of surrounding environments. Olfaction involves a pathway of biochemical and electrophysiological processes, which allows the conversion of molecular information into sensations. Disturbances in the olfactory function have been investigated mainly in neurological/neurodegenerative disorders such as Alzheimer's and Parkinson's diseases; impaired sense of smell has been associated with depressed mood. Only recently, smell capability was tested in other diseases, particularly autoimmune diseases. Shoenfeld and colleagues opened this chapter showing that patients affected with systemic lupus erythematosus (SLE) have disturbances in their olfactory functions and revealed its association with neuropsychiatric manifestations of the disease. This evidence was confirmed in experimental models and replicated in other SLE populations. The connection between autoimmunity and the sense of smell was lately emphasized by studies on patients with Sjögren's syndrome and in patients with other autoimmune/immune-mediated diseases, such as polydermatomyositis, recurrent spontaneous abortion, and hereditary angioedema. Genetic susceptibility and hormonal and environmental factors may play a role in these conditions. Olfactory receptor gene clusters are located in proximity to key locus of susceptibility for autoimmune diseases such as the major histocompatibility complex, suggesting not only a physic linkage, but a functional association. Nonetheless, gender- and hormone-mediated effects are fundamental in the development of autoimmune diseases. The different connections between smell and autoimmunity, genes and hormones may suggest that this is another tessera of a mosaic which is waiting the answer of Oedipus.
嗅觉是一种古老的感觉模态，对于采样和感知周围环境的化学成分至关重要。嗅觉涉及生化和电生理过程的途径，允许将分子信息转化为感觉。嗅觉功能的障碍主要在神经/神经退行性疾病中进行了研究，如阿尔茨海默病和帕金森病；嗅觉受损与抑郁情绪有关。直到最近，人们才在其他疾病中测试了嗅觉能力，特别是自身免疫性疾病。Shoenfeld 及其同事开启了这一章，表明系统性红斑狼疮（SLE）患者的嗅觉功能存在障碍，并揭示了其与疾病的神经精神表现有关。这一证据在实验模型中得到了证实，并在其他 SLE 人群中得到了复制。自身免疫与嗅觉之间的联系最近在干燥综合征患者和其他自身免疫/免疫介导性疾病患者（如多发性皮肌炎、复发性自发性流产和遗传性血管性水肿）的研究中得到了强调。遗传易感性、激素和环境因素可能在这些疾病中起作用。嗅觉受体基因簇位于自身免疫疾病的关键易感基因座附近，如主要组织相容性复合体，这不仅表明物理联系，而且表明功能联系。尽管如此，性别和激素介导的作用是自身免疫性疾病发展的基础。嗅觉与自身免疫、基因和激素之间的不同联系可能表明，这是等待俄狄浦斯回答的马赛克的另一个嵌板。
