National Institute of Geriatrics, Rheumatology and Rehabilitation, Early Arthritis Clinic, Spartanska1, Warsaw, Poland.
Curr Opin Rheumatol. 2019 Sep;31(5):475-483. doi: 10.1097/BOR.0000000000000622.
The purpose of this article is to draw attention to the role of Epstein-Barr virus (EBV) virus in the pathogenesis of the primary Sjögren's syndrome. The article introduces the problem of consequences of EBV acute infection, and its reactivation, in association with the immune response modulation by the virus and with an increased risk of developing systemic autoimmune diseases and EBV-associated cancers.
The knowledge about the mechanisms by which the virus may stay for years in a latent phase, unrecognized by the host response immune cells is constantly expanding. There are several mechanisms and theories about EBV influence on the autoimmune process in Sjogren's syndrome (pSS), including the similarity (molecular mimicry) between viral EBNA-2 protein and Ro-60 antigen or EBER-1 and EBER-2 viral proteins and La antigen.
The influence of EBV infection on the development and course of pSS has been proven. It has also been established that both EBV and pSS result in the increased risk of tumor (especially lymphoma) development. In the light of these findings, new ways to manage EBV infections are being sought. Optimal methods for assessing EBV infection status are being devised. Research also aims at finding therapies, which target EBV through the inhibition of the autoimmune process and of viral activity. The present article is an attempt to discuss the most important phenomena and elements linking EBV infection to the primary Sjögren's syndrome.
本文旨在引起人们对 Epstein-Barr 病毒 (EBV) 在原发性干燥综合征发病机制中的作用的关注。文章介绍了 EBV 急性感染及其再激活的后果问题,以及病毒对免疫反应的调节作用及其与系统性自身免疫性疾病和 EBV 相关癌症风险增加的关系。
宿主免疫细胞对病毒持续潜伏而不被识别的机制的认识正在不断扩大。关于 EBV 对干燥综合征 (pSS) 自身免疫过程的影响,有几种机制和理论,包括病毒 EBNA-2 蛋白与 Ro-60 抗原或 EBER-1 和 EBER-2 病毒蛋白与 La 抗原之间的相似性(分子模拟)。
已证实 EBV 感染对 pSS 的发展和病程有影响。也已经确定 EBV 和 pSS 都会增加肿瘤(尤其是淋巴瘤)发展的风险。鉴于这些发现,正在寻求管理 EBV 感染的新方法。正在设计用于评估 EBV 感染状态的最佳方法。研究还旨在寻找针对 EBV 的治疗方法,通过抑制自身免疫过程和病毒活性来靶向 EBV。本文试图讨论将 EBV 感染与原发性干燥综合征联系起来的最重要现象和因素。